Application Of Echogenic Needles In Postoperative Analgesia Nerve Block

https://www.nature.com/articles/s41598-024-72620-8

1. Clinical Pain Points

Postoperative pain management is key to improving patient recovery quality, and peripheral nerve block is the core means of precise postoperative analgesia. However, traditional postoperative nerve block has many deficiencies: ordinary puncture needles have poor positioning accuracy, unable to accurately lock the surgical involved nerve range, resulting in insufficient postoperative analgesia and severe pain rebound. Inaccurate drug injection position leads to uneven anesthetic diffusion, partial nerve block failure, and patients still need to take a large number of opioid analgesics after operation, resulting in adverse reactions such as nausea, vomiting and constipation. In addition, traditional block technology has unstable analgesia duration, poor pertinence for postoperative incision pain and deep tissue pain, and is easy to affect patients' early ambulation and functional rehabilitation, prolonging hospital stay and reducing medical treatment efficiency.

2. Working Principle of Echogenic Nerve Block Needles

Echogenic nerve block needles realize efficient and durable postoperative analgesia through dual precise positioning and targeted drug delivery technology. The high-sensitivity echo enhancement structure can clearly display the needle trajectory and tip position in postoperative scar tissue and surgical incision surrounding tissues, accurately locate the nerve plexus and branch nerves related to surgical pain. The electrical nerve stimulation system can accurately identify the pain-dominant nerves that cause postoperative incision pain and deep tissue pain, realizing targeted locking of analgesic targets. Under the dual verification of ultrasound visualization and nerve electrical feedback, the needle tip is accurately placed in the optimal nerve sheath space, and long-acting local anesthetics are injected uniformly, forming a stable and lasting nerve anesthesia barrier. It can effectively block postoperative pain signal transmission, achieve full-range and long-term postoperative analgesia, and avoid pain rebound and incomplete block.

3. Equipment Classification and Adaptive Scenarios

According to different surgical types and postoperative analgesia cycle requirements, echogenic needles are divided into routine postoperative analgesia type (21G-23G) and long-acting block special type (19G-20G). The 21G-23G routine analgesia echogenic needles are suitable for general surgery, minor orthopedic surgery and superficial tissue surgery postoperative short-term analgesia nerve block, with balanced puncture performance and accurate positioning. The 19G-20G long-acting special echogenic needles are suitable for major orthopedic surgery, thoracic and abdominal surgery postoperative long-term analgesia, with stable needle body structure, which can meet the positioning accuracy requirements of deep tissue long-acting drug injection. All products support multi-specification length customization, adapting to different surgical site depth and nerve distribution characteristics.

4. Standard Operational Guidelines

After completing the surgical operation, evaluate the patient's postoperative pain risk and nerve block range, select the matched echogenic needle specification. Use ultrasound to scan the surgical area and surrounding nerve plexus, determine the target nerve range for postoperative analgesia block. Adopt in-plane precise puncture technique, advance the echogenic needle slowly, monitor the needle entry track in real time through ultrasound images. Turn on the nerve stimulation device to verify the target nerve position, fine-tune the needle tip to the optimal nerve sheath gap. Inject long-acting local anesthetic slowly and evenly in batches, observe the comprehensive diffusion of drugs around the nerve through ultrasound, ensure full coverage of the surgical pain nerve area. After confirming no vascular infiltration and nerve compression injury, withdraw the needle and complete the postoperative analgesia nerve block operation.

5. Practical Clinical Experience

A large number of clinical practices show that postoperative nerve block with echogenic needles has significant advantages over traditional technology. The precise positioning technology realizes full coverage of surgical pain-related nerves, the postoperative analgesia effective rate is increased from 80% to 97%, and the incidence of moderate and severe postoperative pain is reduced by more than 70%. The targeted drug delivery makes the anesthetic drug act directly on the pain nerve, the analgesia duration is extended by 4-6 hours compared with traditional block, and the patient's postoperative opioid drug consumption is reduced by 55%. Patients have significantly reduced postoperative adverse reactions, faster early rehabilitation exercise, shorter hospital stay by 1-2 days on average, and higher overall postoperative comfort and treatment satisfaction. Meanwhile, the accurate block effect avoids nerve injury caused by blind injection, and the postoperative complication rate is extremely low.

6. Summary and sublimation

Postoperative precise analgesia is an important part of modern enhanced recovery after surgery (ERAS) concept. Traditional postoperative nerve block technology is restricted by inaccurate positioning and uneven drug diffusion, resulting in poor analgesia effect and many adverse reactions, which is not conducive to patients' rapid rehabilitation. Echogenic nerve block needles break through the technical limitations of traditional postoperative analgesia with dual-mode precise positioning and targeted drug delivery advantages. It realizes accurate, lasting and full-range postoperative pain block, reduces the dependence on opioid drugs, optimizes patients' postoperative rehabilitation experience, and effectively promotes the implementation of ERAS rapid rehabilitation mode, which has important clinical promotion value.

7. Future Application Prospects and Suggestions

With the comprehensive promotion of ERAS rapid rehabilitation surgery mode, postoperative precise analgesia has become a rigid clinical demand. It is suggested to comprehensively promote the application of echogenic needle nerve block technology in postoperative analgesia of various surgeries, and formulate individualized analgesia schemes according to surgical trauma degree and patient differences. Optimize product matching performance, develop special echogenic needles for thoracic surgery, abdominal surgery and joint surgery postoperative analgesia. Strengthen the combination of echogenic needle block and patient-controlled analgesia technology, build a diversified precise postoperative analgesia system, further improve the level of clinical postoperative pain management, and accelerate patients' postoperative rapid recovery.