الفهرس 
Anatomy and Sono-anatomy of the lower extremityOnly 14 pages are availabe for public view
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Abstract
Lower extremity nerve blocks are becoming an excellent anesthetic choice for lower extremity surgery, a number of highly efficacious peripheral nerve block techniques can be used to provide excellent surgical anesthesia and good postoperative analgesia in patients undergoing wide variety of surgical procedures.
Judiciously and skillfully performed nerve blocks can facilitate pain management, fast-tracking, allow early mobilization, decrease hospital stay, reduce unanticipated hospital admission, and reduce health care costs.
In contrast to other anesthetic techniques, such as general or spinal anesthesia, properly conducted peripheral nerve blocks avoid hemodynamic instability and pulmonary complications; facilitate post-operative pain management and timely discharge.
Additional advantages of peripheral nerve blocks are that they are generally not contraindicated in patients taking anti-coagulants, they can be used in patients having lumbo-sacral disease and avoid the need for airway instrumentation.
It is almost universally accepted that these techniques offer numerous advantages and it is very likely that a trend toward increased interest in peripheral nerve blocks will continue to take place in the near future.
Since the development of regional anesthesia, anesthetists all over the world tried to establish various mechanical aids like radiography to visualize the target nerve.
The benefits of directly visualizing targeted nerve structures are significant as it allows the anesthetist to reposition the needle in the event of maldistribution and also it allows the anesthetist to monitor the distribution of local anesthetic.
One of the major benefits of direct visualization of the targeted nerve in regional anesthesia is that it makes it possible to block nerves with complex anatomical route as for example infrapatellar nerve block for post operative pain management in arthroscopic knee surgeries.
It is relatively easy to acknowledge that ultrasound guidance should be used, but there are significant obstacles to implementation as availability of high cost equipment and minority of experienced regional anesthetists.
The high cost will limit its immediate general availability, but continued technical development and cost reduction will change this ultimately.
The technique can be established in a cost-efficient manner as portable ultrasound systems with high-frequency probes are now available. It is hoped that these systems will promote the routine use of ultrasound guidance in regional anesthesia.
The the ultrasound machine may become an important component of the anesthesia machine of the future due to the increasing role in vascular access, trans-esophageal echocardiography (TEE) & regional anesthesia.
It is therefore justified to expect anesthetists to acquire the skills to use ultrasound guidance in clinical practice.