A fine needle, guided in real-time by ultrasound, precisely reaches the target nerve. Local anesthetic slowly diffuses, accurately blocking pain signals from the surgical site.
In the postoperative recovery ward, 68-year-old Ms. Maria actively flexes and extends her left leg, which just underwent total knee replacement surgery. A patient in the neighboring bed asks in surprise, "Aren't you in pain? When I had the same surgery last year, the pain kept me awake all night on the first day."
Ms. Maria smiles and replies, "The doctors used a new technique on me called ultrasound-guided nerve block. Now I only feel slight swelling at the wound site."
This scene is becoming increasingly common in hospitals. With the promotion of the Enhanced Recovery After Surgery (ERAS) concept, postoperative pain management has become a crucial indicator of healthcare quality.
Traditional postoperative analgesia relies heavily on opioids. However, side effects like nausea, vomiting, constipation, and respiratory depression often cause significant distress for patients. Multimodal analgesia—the combined application of analgesic methods with different mechanisms of action—has become the gold standard in modern postoperative pain management.
Within this paradigm, ultrasound-guided peripheral nerve blocks (UGPNBs) are rapidly emerging as a pivotal component.
01 The Dilemma of Traditional Analgesia
Globally, over 300 million patients undergo surgery annually, with approximately 80% experiencing moderate-to-severe postoperative pain. Opioids have long been the "mainstay" of postoperative analgesia, but their side effects are significant: about 30% of patients experience nausea and vomiting, 15% suffer constipation, and severe cases may even involve respiratory depression.
More concerningly, inadequate postoperative pain control can trigger a cascade of adverse effects: delayed wound healing, deep vein thrombosis, increased risk of pneumonia, and the potential development of chronic pain in approximately 10%-50% of patients.
Facing these challenges, the anesthesiology community proposed the multimodal analgesia strategy. The core of this concept lies in combining analgesic techniques with different mechanisms to enhance efficacy while reducing side effects.
Peripheral nerve blocks, especially precise blocks guided by ultrasound, are playing an increasingly vital role within this strategy.
02 The Key Technological Breakthrough
Peripheral nerve blocks are not new, but traditional "blind" techniques (landmark-based) have significant limitations: success rates vary widely (38%-75%), and complication risks are higher.
The introduction of ultrasound technology revolutionized this field. Using high-frequency probes, nerves, blood vessels, and surrounding structures become clearly visible. Operators can guide the needle precisely to the vicinity of the target nerve under real-time visualization.
Taking knee surgery as an example, the traditional femoral nerve block provides good analgesia but inevitably causes quadriceps weakness, increasing fall risk. Conversely, the ultrasound-guided adductor canal block (primarily targeting the saphenous nerve) provides equivalent analgesia while preserving over 90% of quadriceps strength.
"Ultrasound visualization not only facilitates identification, localization, and guidance, but also reduces complication rates, especially pneumothorax, accidental vascular puncture, and local anesthetic systemic toxicity (LAST)," states the Expert Consensus on Ultrasound-Guided Brachial Plexus Block.
Innovations in technical details are equally important. The in-plane needle approach allows the operator to visualize the entire needle path; short-axis nerve imaging facilitates distinguishing nerves from surrounding tissues; hydrodissection helps confirm needle tip position.
03 Revolutionizing Clinical Application
The clinical application of ultrasound-guided nerve blocks is rapidly expanding:
This technology also extends to chronic pain management. Ultrasound guidance has significantly improved the success rates of blocks like the lateral femoral cutaneous nerve block for meralgia paresthetica and the suprascapular nerve block for frozen shoulder.
04 Frontiers of Technological Innovation
To extend the duration of nerve blocks, researchers have developed several innovative techniques:
05 Safety and the Future
Although ultrasound guidance significantly improves safety, nerve blocks still carry inherent risks. The most serious is Local Anesthetic Systemic Toxicity (LAST), occurring in approximately 2.7 per 10,000 cases. Standard treatment upon occurrence is immediate intravenous injection of 20% lipid emulsion.
Nerve injury is rare (~0.9 per 1,000 cases), but operators must be vigilant for sudden severe pain or paresthesia during injection, which may signal intraneural injection.
Future directions are emerging:
As noted in the Expert Consensus on Ultrasound-Guided Brachial Plexus Block: "Ultrasound technology has driven the evolution of brachial plexus blocks towards individualization and precision." This assessment equally applies to the entire field of peripheral nerve blockade.
With the proliferation of portable ultrasound devices, this technology is moving beyond the operating room into emergency departments and community health centers. In the future, patients managing pain at home via remotely monitored continuous nerve block catheters may become the norm for postoperative recovery.
When pain is precisely controlled, surgery ceases to be a painful memory. As patients sleep peacefully on their first postoperative night, a new era of pain-free recovery has quietly arrived.
Dili, April 22, 2025-The handover ceremony of medical supplies donated by the Chinese government to Timor-Leste was successfully held at the Hospital National Guido Valadares. Wang Wenli, Chinese Ambassador to Timor-Leste, and Sr. Narciso Fernandes, The Director of the National Policy and Cooperation Department at Timor-Leste's Ministry of Health, signed the handover documents on behalf of their respective governments and delivered speeches at the ceremony.The event was attended by Zhao Suocheng, Counselor of the Chinese Embassy in Timor-Leste, the Director of Timor-Leste National Hospital, relevant government officials, and members of the Chinese Medical Team stationed in Timor-Leste.This donation not only demonstrates the profound friendship between China and Timor-Leste, but also provides new impetus for bilateral cooperation in the healthcare sector. The assistance reflects China's commitment to supporting Timor-Leste's public health development and enhancing the well-being of its people.
The full name of ICU is Intensive Care Unit, a specialized department dedicated to treating critically ill patients. It is equipped with advanced monitoring devices and medical technologies, staffed by a professional healthcare team providing 24hours continuous care and treatment.
Understanding Health Preservation in Tropical Regions from the theory of Traditional Chinese Medicine
Understanding Health Preservation in Tropical Regions from the theory of Traditional Chinese Medicine
Hello,frends, I am Dr. Xie Guoping, a urologist of the 10th Chinese Medical Team to Timor-Leste HNGV,from The First Affiliated Hospital of Chengdu Medical College.Today I will give you some basic knowledge about the prevention and treatment of urinary stones.
DILI: Timor-Leste, Australia and Osaka Gas have made “meaningful progress” toward reaching a final development agreement on the stalled Sunrise natural liquified gas project in the Timor Sea, Australia’s Woodside Energy said in a joint statement on Friday.
VATICAN: The Vatican on Monday released Pope Francis’ official schedule for his visit to Timor-Leste, Papua New Guinea, Indonesia and Singapore, which starts on 2 September.
DILI: Researchers working in Timor-Leste for the first time have recorded evidence of reproduction in blue whales, including footage of a mother nursing her calf, in a world-first effort announced on Thursday that spotlights the richness of Timor-Leste’s marine life.
DILI: Timor-Leste on Monday began laying its first undersea fibre optic communications cable through the Timor Sea as part of a state-run project to bring high-speed and reliable internet to the country for the first time.
DILI: Timor-Leste and Thailand have agreed to put in a place a 30-day mutual visa exemption for tourists with ordinary passports, the Thailand Government House said on Tuesday, as the two countries seek to promote tourism between them further.
DILI: Indonesian Academic and Policy Maker Professor Dewi Fortuna Anwar was awarded Timor-Leste’s top civil honour on Friday at a ceremony at Presidential Palace.
DILI: Brunei King Sultan Hassanal Bolkiah will travel to Dili on his first state visit since diplomatic relations were established between Timor-Leste and Brunei in May 2002, Timor-Leste government said on Thursday.