[Comparative study of performance of lower extremities blocks under ultrasonography and nerve stimulator guidance].

The aim of the study was to conduct a comparative analysis of regional anesthesia under neurostimulator, ultrasound guidance, and under combined guidance of the neurostimulator and ultrasound to ensure the safe and effective control of regional anesthesia with minimal discomfort for the patient. Ultrasound allows to gain significantly higher quality scores of local anesthesia than nerve stimulator control, to significantly reduce the number of needle extra insertions, needling cases, transposition, addition of general anesthesia, the number of unsuccessful blocks, reduce needle manipulation, significantly increase the occurrence of cases of complete blockade (sensitive and motor) on 30 min., causes less discomfort for patients. The use of ultrasound does not exclude the use of nerve stimulator as an additional means of verification of correct needle placement, particularly in the early stages of mastering the technique. The research combined use of ultrasound and nerve stimulator significantly decrease unsuccessful blockade and transposition need for a needle during manipulation. However, the difference between some indicators of quality of regional anesthesia is statistically unreliable; it requires further randomized and double blind studies on large patient groups, for different blockages.

[Main sonographic parameters of regional anesthesia conduction in the lower extremities under ultrasound guidance].

The purpose of this research is to study the main sonographic parameters of nerve and needles, as well as some methodological aspects of regional anesthesia under ultrasound control, comparing the results of different methods, approaches to the performance of lower limbs regional anesthesia under ultrasound guidance, the formulation of general principles for optimization of visual identification of the needle, catheter during anesthesia with the definition of localization, structure and distribution of entered anesthetic. The ultrasound is an effective method of control of the lower extremities regional anesthesia. The further study and improvement of methodological aspects is required. With the proposed method is possible to conduct qualitative sonographic navigation with high efficiency in all patients.