Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms.

Nerve hydrodissection (HD), a technique used when treating nerve entrapments, involves the injection of an anesthetic, saline, or 5% dextrose in water to separate the nerve from the surrounding tissue, fascia, or adjacent structures. Animal models suggest the potential for minimal compression to initiate and perpetuate neuropathic pain. Mechanical benefits of HD may relate to release of nervi nervorum or vasa nervorum compression. Pathologic nerves can be identified by examination or ultrasound visualization. The in-plane technique is the predominant and safest method for nerve HD. Five percent dextrose may be favored as the preferred injectate based on preliminary comparative-injectate literature, but additional research is critical. Literature-based hypotheses for a direct ameliorative effect of dextrose HD on neuropathic pain are presented.

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© 2020 Lam et al.

Déclaration de conflit d'intérêts

Some of the materials and pictures contained in this manuscript have been used in previous presentations during international academic conferences. The most recent one was the Annual Conference of the Australian Association of Musculoskeletal Medicine on 24–27 October 2019 in Brisbane, Australia. The previous one was the International Symposium of Ultrasound for Regional Anesthesia and Pain Medicine (ISURA 2019) on 9–11 May 2019 in Porto, Portugal. The authors report no conflicts of interest in this work.