Review of essential understanding of ultrasound physics and equipment operation

Abstract

Ultrasound (US) is being extensively used an imaging tool in regional anesthesia (RA) and pain practice. Although it was first used in a regional block in 1978, it was only in 1994 that the first direct use of US in RA was reported. Like any other medical tool, its utility is only realized when the performing physician is able to understand the principles behind its application. Efficient use of US also requires an understanding of physical variables which can be suitable modified to produce a clear image of the structure of importance. This brief narrative review summarises the advantages of US in RA and pain practice over the conventionally used localising or imaging tools. The second section deals with the physics behind US. It highlights the necessary physical concepts such as wavelength, frequency and generation of US waves. It also informs the reader about the possible US and tissue interactions, use of US transducers and their differences. The third section deals with understanding the control variables in a typical US machine and how they could be modified to improve the image quality. The final section highlights the various artifacts that could be associated.

Keywords: Ultrasound physics, Ultrasound in regional anesthesia, Essential concepts of ultrasound, Ultrasound basics, Artifacts

Core tip: This review summarises the essential concepts of ultrasound (US) physics and equipment operation. To make the best use of US in regional anesthesia and pain practice, it is important to obtain a quality image. Since anesthesiologists do not depend on any image technician, it is necessary for them to understand the operating principles of the equipment. The physician will also have to choose an appropriate transducer, and make suitable adjustments in gain and focus. All these concepts are detailed in simple terms along with necessary figures for easy understanding.