EMERGENCY AIRWAY-MANAGEMENT IN ANAESTHESIA AND EMERGENCY MEDICINE

method for many applications of peripheral nerve blocks in order to achieve an increase of success rate and to reduce the risk of complications. Methods. In order to perform ultrasonic guided interscalene brachial plexus blocks, the use of transducers with frequencies between 7.5 and 12 MHz are essential for good quality imaging. The sonographic image of peripheral nerves is described either as hypoechoic or hyperechoic. There are several reasons that in¯uences the sonographical appearance of nerves such as the size of the nerve, the frequency used, and the angle of incidence of the ultrasound beam. The sonographic imaging of the brachial plexus is very feasible in the space between the anterior and middle scalene muscle. Nerves are visualised as multiple round or oval hypoechoic areas encircled by a relative hyperechoic horizon. Ultrasonic guided brachial plexus blocks are not only determined by the visualised positioning of the tip of needle, but rather by monitoring of the injection of local anaesthetics as they encircle the roots of the brachial plexus. In the case of misplacement of the needle with corresponding distribution of local anaesthetic, the needle position can be altered through this method until normal distribution is seen. Results. In several studies (2,3) the use of ultrasound have been shown to be bene®cial for success rate, onset time and the reduction of risk of complications. Conclusion. Ultrasonography is an ideal method to detect peripheral nerve structures. Thus, this mean can be used for region anaesthetic blocks for needle guidance as well as local anaesthetic control resulting in a perfect blockade and a visible reduction of risk factors