M A Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 0 5
Though they're challenging, there's no question that regional
blocks offer distinct advantages for providers who master
them. Fortunately, one of the big challenges — navigating
depth by means of 2-dimensional visualization — may soon
be history.
Three-dimensional ultrasound is well established in
echocardiography, obstetrics, and intravascular medicine, but
the development of 3D transducers and ultrasound machines
for regional anesthesia and block placement has lagged
behind, says Mike MacKinnon, co-owner of ce2you.com, an
ultrasound and vascular regional anesthesia education com-
pany.
Cost and technology are still obstacles — current 3D technology has an upper frequency maximum
of 7 MHz, which limits image resolution and utility for certain blocks — but time will improve technolo-
gy, bring costs down and work out all the kinks, says Mr. MacKinnon, adding, "I believe this technology
is a decade away from mainstream adoption."
And then? "The advantages of a 3D image in real time cannot be overstated," he says. Anesthesia
providers, he says, will be able to deliver local anesthetic more precisely along the nerve, since needle
placement will be easier; they'll be able to better identify anatomically close dangerous structures
such as pleura and blood vessels; they'll be better at avoiding complications, such as intravascular
injection of local anesthetics; and they'll be able to manipulate images in real time, providing data that
a 2-dimensional format can't produce.
It all adds up to more-precise blocks with less local, less risk of local toxicity and increased safety.
Reducing the volume of local may also promote safety, as research begins to suggest that larger volumes
may damage nerves in the long term. "The difference between 2D and 3D ultrasound is analogous to the
difference between plain X-ray and computerized tomography," says Mr. MacKinnon. "It is a total leap
forward in every way." — Jim Burger
THE FUTURE OF BLOCKS?
3D Ultrasound Is on the Way
• LEAP YEAR COMING Mainstream adoption may be a decade
away, but 3D ultrasound for regional blocks is likely to be a
game-changer.
Pamela
Bevelhymer,
RN,
BSN
