Ultrasonic Based

The ultrasonic wave is generated by a piezoelectric transducer in the probe of the ultrasonic diagnostic instrument. The probe receives the ultrasonic wave as well as the ultrasonic wave, and processes it to present the ultrasonic image through the display screen. The nerve tissue under ultrasound is composed of hypoechoic nerve fibers and hyperechoic intranerve connective tissue. In the cross section, the peripheral nerve tissue is usually round, oval or triangular honeycomb structure. In the longitudinal section, the peripheral nerve tissue often appears as a zonal structure. The typical ultrasound image of peripheral nerve is a relatively hyperechoic area surrounding a hypoechoic area. In fact, the Angle and intensity of the ultrasonic reflection depend on the Angle of the ultrasonic wave relative to the long axis of the nerve. Only the reflected echo beam of the ultrasonic wave perpendicular to the long axis of the nerve can be acquired. Therefore, the linear array probe with parallel acoustic beam is more suitable for neural ultrasound. The choice of probe frequency is usually determined by the type of nerve block, and it is believed that high frequency probes can provide a clearer resolution of nerve tissue.

In the implementation of ultrasound-guided nerve block, different ultrasonic parameters should first be adjusted according to the different types of nerve block, so as to clearly show the anatomical structure of the target area, and determine the appropriate puncture point and puncture path. Sterilize the skin at the puncture site and the ultrasound probe (conventional disinfectants can be used to sterilize the probe), and wrap the probe with sterile membrane or sterile gloves. Then, the ideal puncture plane was determined again, the probe was fixed, and the appropriate puncture needle was selected to guide the puncture to the target area for nerve block (usually the needle with a size of 22G40-80mm is selected). The imaging quality of ultrasonic puncture needle directly affects the safety and success rate of nerve block. When the needle intersects the sound wave vertically, the imaging effect is the best, which is a high-echo beam with sound shadow. Sometimes, the target nerve cannot be clearly identified due to the small diameter or artifacts of the target nerve. Therefore, it is very important to accurately locate the landmark anatomical structure in the process of nerve deformation.

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