Table Of ContentEryk Eisenberg
Elisabeth Gaertner
Editors
Ultrasound in Peripheral,
Neuraxial and Perineuraxial
Regional Anaesthesia
123
Ultrasound in Peripheral, Neuraxial and
Perineuraxial Regional Anaesthesia
Eryk Eisenberg • Elisabeth Gaertner
Editors
Ultrasound in Peripheral,
Neuraxial and Perineuraxial
Regional Anaesthesia
Editors
Eryk Eisenberg Elisabeth Gaertner
Département d’anesthésie et réanimation Département d’anesthésie et réanimation
Clinique Pôle Santé République chirurgicale
Clermont-Ferrand, France Hôpitaux Civils de Colmar
Colmar, France
ISBN 978-3-031-08803-2 ISBN 978-3-031-08804-9 (eBook)
https://doi.org/10.1007/978-3-031-08804-9
© Springer Nature Switzerland AG 2023
The Work was first published in 2007 by Editions Arnette with the following title: Echographie en anesthésie régionale
péeriphérique, médullaire et périmédullaire, and in 2014 by Editions Arnette John Libbey Eurotext with the following
title: Echographie en anesthésie régionale péeriphérique, médullaire et périmédullaire 2nd edition. Videos are
published with kind permission of copyright holders: Eisenberg, Fouché, ADN. All rights reserved.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed
to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty,
expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To my sons, Sasha and Solal.
May I never disappoint you.
“We are a biological accident which does what it may”—Jacques Brel
“Without art, a gift is nothing other than a dirty habit”—Georges Brassens
(Le mauvais sujet repenti)
“Two intellectuals seated will go less far than an imbecile who
is walking”—from Michel Audiard
“I do not wish to achieve immortality by means of my work. I wish to achieve
immortality by not dying!”—Woody Allen
Foreword
“Ultrasound is now making so much noise that we are beginning to hear it”.—Dr Daniel
Lichtenstein
This book is the fruition of a long-term work started in 2004, for which the first result was
the first edition published in 2007. I am happy to state that 7 years after its publication, its
content has continued to be fully of current interest. Nevertheless, a few updates are now
required:
Technical advances in ultrasound imaging have made it necessary to create an updated ico-
nography. Although a few images in the work are the result of high-end imaging equipment
(3D/4D ultrasound images and CT scan ultrasound fusion imaging, MRI ultrasound), almost
the totality however has been carried out with ultrasound imagers which are affordable to the
majority of anaesthesia departments. The technical performance of this equipment does not
cease to increase, image quality is being refined in an astonishing manner, but however it is
prudent to not have “blind faith in our ability to see”.
By echoing (no pun intended) the adage “Give a small boy a hammer and he will find that
everything he encounters needs a pounding” (Abraham Kaplan), the daily use of ultrasound is
being extended to new medical techniques: anaesthetics, analgesics, diagnostics, etc. Therefore,
it was appropriate to offer the reader a description of some of them.
Lastly, notwithstanding the citation according to which “experience is a lantern hooked
onto one’s back and which only illuminates the path travelled” (Confucius), of course it has
been inescapable to allow “the light of experience” to mix somewhat the present and future
enlightenment of our practices.
vii
From the Same Publisher
Principes et protocoles en anesthésie pédiatrique (3rd edition), F. Duflo, S. Combet, M. de
Queiroz Siqueira, 2014.
Le blessé de guerre, S. Mérat, 2014.
Anesthésiste-Réanimateur/Chirurgien: un seul bloc, V. Travers, H. Cuche, E. Gaertner,
2013.
La communication dans le soin. Hypnose médicale et techniques relationnelles, F. Bernard,
H. Musellec, E. Gaertner, 2013.
Médicaments en anesthésie (3rd edition), B. Dalens, 2013.
Hépatologie aiguë en anesthésie, réanimation, urgence, F. Aubrun, S. Duperret, 2013.
Kétamine (2nd edition), G. Mion et al., 2012.
Cœur et anesthésie (2nd edition), P. Coriat, Y. Le Manach et al., 2012.
Les Monitorages des paramètres physiologiques en situation critique, J.-J. Lehot,
M. Cannesson et al., 2012.
Guide pratique d'anesthésie locorégionale 3rd edition), X. Paqueron and Y. Cimino, 2012.
Fiches techniques en salle de surveillance post-interventionnelle, C. Péraldi et al., 2012.
Intubation. De l'oxygénation à l'intubation difficile, C. Erb, H. Menu, É. Wiel, 2012.
Protocoles d'anesthésie-réanimation obstétricale (2nd edition), P. Dailland et al., 2011.
Procédures anesthésiques liées aux techniques chirurgicales, S. Mérat et al., 2011.
Guide pratique d'anesthésie locorégionale pédiatrique: clinique et échographie, S. Combet,
M. De Queiroz Siqueira and F. Duflo., 2011.
Anesthésie et analgésie locorégionale en chirurgie abdominale et périnéale, M. Beaussier,
P. Niccolaï et al., 2010.
Anesthésie en chirurgie orthopédique et traumatologique, E. Gaertner et al., 2010.
Mémo Cardio en urgence, F. Lapostolle and J.-P. Torres, 2010.
Hypnose, douleurs aiguës et anesthésie, Cl. Viroe and F. Bernard, 2010.
Comprendre les émotions en anesthésie réanimation, J.-C. Lleu, 2010.
Hygiène en anesthésie (4th edition), A.-M. Saire-Mauffrey, E. Gaertner, H. de Montclos
et al., 2010.
Les Produits de l'anesthésie (4th edition), X. Sauvageon et al., 2010.
Anesthésie et réanimation du patient obèse, J.-E. Bazin, P. Coriat et al., 2009.
Nouveaux risques en anesthésie réanimation, J.-J. Lehot, M. Canesson et al., 2009.
Principes et protocoles en anesthésie pédiatrique (2nd edition), F. Duflo et al., 2009.
Manuel d'échographie en réanimation et service d'urgence, V. Noble, B. Nelson,
A.N. Suttingco, translated by E. Gaertner, 2009.
Iatrogénie et toxicologie en urgence, F. Baud and R. Bédry, 2009.
Douleur, inflammation et auto-immunité à l'usage des spécialités médicales, M. Sorel et al.,
2009.
Précis d'anesthésie clinique, P.G. Barash, B.F. Cullen, R.K. Stoelting, E. Gaertner, 2008.
Urgences et infections, C. Martin, 2008.
Anesthésie, analgésie et sédation du patient âgé, F. Aubrun, 2008.
ix
Foreword to the 2014 French Edition
Seven years after the publication of the first edition of Echographie en anesthésie régionale
périphérique (Ultrasound in peripheral regional anaesthesia), edited by Dr. Eryk Eisenberg,
we had the privilege to preview the second edition of this well-established, outstanding book.
It is with pleasure that we welcome the second edition with a few words about the author and
his collaborators. Dr. Eisenberg is one of the most fervent educators in the field of ultrasound-
guided regional anaesthesia and peripheral nerve blocks. His must-go-to annual symposium,
traditionally hosted in December in Clermont-Ferrand, is the most popular regional anaesthe-
sia educational event in France, with rich tradition, well received and attended by delegates
from all over Europe. The collaborators chosen by Dr. Eisenberg for this second edition are
some of the best-known practitioners and educators in the field. It is thus no surprise that this
team lead by Dr. Eisenberg has crafted probably the most comprehensive volume on ultra-
sound in regional anaesthesia to date. The first edition (2007) that comprised 140 pages has
been nearly tripled in volume and now features nearly 400 pages, 500 ultrasound images and
nearly 50 anatomical dissections. The new edition is also accompanied by a dedicated website
with videos of state-of-the-art techniques, richly accompanied by didactic and illustration
material.
The scope of the book is uniquely comprehensive and logically organized. We particularly
value the utmost didactic approach to illustrations with multiple diagrams, picture-in-picture
samples and meticulous labelling of the images.
Aesthetic choice of transparent colours and miniature labels to avoid distraction from the
relevant detail are not only effective but also artistic. The illustrations and images are all of top
quality and consistent in style. The vignetting treatment of images to unclutter the unnecessary
detail will also be appreciated by readers. The ultrasound images are outstanding and carefully
selected for didactics and simplicity to demonstrate the most clinically relevant situations.
Importantly, they have a real-life appearance, including actual needle paths and desired dispo-
sition of injectate during nerve block procedures; most are from the original database of Dr.
Eisenberg. All the supplementary didactic material is authoritative and presented as an artful
balance of years of clinical experience by the Editor and a summary of the peer-reviewed
literature.
In summary, this second edition, Ultrasound in peripheral, neuraxial and perineuraxial
regional anaesthesia, is truly an amazing text didactically and aesthetically. It is a must-have
book for anyone interested in learning, advancing the existing knowledge or teaching
ultrasound- guided regional anaesthesia. Sincere congratulations to the Editor and all of the
contributors on producing such an educational masterpiece.
The New York School of Regional Anaesthesia (NYSORA) Admir Hadzic
New York, USA
Faculty of Medicine Manoj Kumar Karmakar
The Chinese University of Hong Kong
Hong Kong, Hong Kong
xi
Postscript to the 2014 French Edition
Writing a postscript for the Ultrasound in peripheral, neuraxial and perineuraxial regional
anaesthesia book coordinated by Dr Éryk Eisenberg is an honor and a privilege. This new edi-
tion arrives in a timely manner, 7 years after the first edition (Ultrasound in peripheral regional
anaesthesia), to further strengthen the nationally recognized characteristic of the book as a
reference work.
Dr. Éryk Eisenberg knew how to work with experts in the field, who succeeded in their
project, in writing of each chapter of the volume, of combining an original presentation with
an educational aspect and a very high level of pictorial and iconographic quality, without over-
looking comprehensiveness in the clinical approach to peripheral, compartmental or spinal
nerve blocks.
The vast majority of techniques in regional anaesthesia are perfectly discussed. Many tech-
niques have been added to the first edition, and other chapters have been brilliantly updated.
This work contains in fact 364 pages which makes it a pleasure to read, including over 500
original illustrations, enhanced by almost anatomical transparencies, the assumed and real
trajectory of needle insertion and of catheters, and of discrete but basic annotations. The qual-
ity of the images and of the videos is unequalled and the references are complete.
Dr. Éryk Eisenberg is an expert clinician in ultrasound-guided regional anaesthesia. He is a
recognized and respected as leading opinion-maker in the field. He worked in collaboration
with other clinicians, all of whose names appear under the subject references and who have
perfectly combined scientific rigorousness and clinical spirit. They jointly knew how to pro-
vide academic and practical meaning, in the innovative use of ultrasound in regional anaesthe-
sia. This work, together with a user-friendly and very complete website, is without a doubt the
ultimate French-language reference in this innovative field of anaesthesia and intensive care.
Reading of the book Ultrasound in peripheral, neuraxial and perineuraxial regional anaesthe-
sia undoubtedly has convinced you of this.
We extend our heartfelt congratulations and our accompanying support on this excellent
teaching tool.
Department of Intensive Care-Anaesthesiology Xavier Capdevila
CHU: University Hospital Centre
Montpellier, Lapeyronie Hospital
Montpellier, France
Department of Anaesthesia Hervé Bouaziz
University Regional Maternity of Nancy, CHU
Nancy, France
xiii
Acknowledgements
To my friends and family, without whom nothing would be.
To my wonderful children, an essential, nourishing sap by each second, whose many
attempts at making my “labour” less arduous have always been crowned by success!
“Here Dad, I made you some little computers to help you finish your book faster!”
To my friends (who know who they are) for being there to offer their support.
To all men who attempt to seek to push back the “sterile and mute abyss, which swallows
up what we hardly are”—Fernando Pessoa (The Book of Disquiet)
To Jean-David who one day told me: “Ignore things doesn’t matter, what does matter, how-
ever, is not knowing where to look”.
I wish from the bottom of my heart that you managed to find the answers that you went so
far to seek, so very far…
“Each man during his night goes off toward his light”.—Victor Hugo
To our patients (from patior: to tolerate, to endure):
“Our life is a woven wind”.—Joseph Joubert
For the iconography:
– PHOTOGRAPHS: Valentin UTA (www.valentinuta.com)
– Models of photographs: Laetitia Aurières, Jean Halberstadt
– ILLUSTRATIONS: Élisabeth FOUCHÉ (ADN) and Guillaume BLANCHET
I warmly thank each and every person who accepted to be associated with this work by
providing his or her knowledge, professionalism, passion and talent:
xv
