Ultrasound in Pain Management: By Dr. G.P. Dureja

September 25, 2018

A decade ago, interventional procedures were performed under fluoroscopy or CT guidance, and few interventions were done blindly through landmark technique by pain management practitioners. Today, invasive procedures & joints injections are no longer performed blind and potential complications like pneumothorax, intravascular injections can be avoided with the help of real-time ultrasonography.

Dr. G.P. Dureja is the Head & Director at Delhi Pain Management Centre, India’s 1st dedicated and leading Pain Hospital with 5 branches across Delhi-NCR region. In 2009, he began using a Sonosite Micromaxx ultrasound system for musculoskeletal studies. In the intervening years. Dr. Dureja has become passionate about using ultrasound in his routine practise.

"Currently, he is using Sonosite SII ultrasound system for doing musculoskeletal examinations (shoulder, elbow, wrist, knee, hip, ankle) and also performs several USG guided pain procedures, including celiac plexus, illio-guinal hypogastric, intercoastal block, sacro-iliac joint, facets joints, piriformis muscle, etc."

According to Dr. Dureja, ultrasound has several advantages over other imaging modalities for interventional procedures. Ultrasound produces no ionizing radiation. Although limited in its capability to see through bony structures, ultrasonography can visualise soft tissues and vascular structures. Dr. Dureja still prefers to do few difficult spine blocks like cervical spine, or in obese patients, using fluoroscopic imaging with X-ray. Ultrasound provides real-time images of various soft tissues and needle advancement, and allows the patient to move (unlike CT or MRI). Ultrasonography is also significantly more affordable than other imaging modalities.

"Compact ultrasound enables real-time, point-of-care diagnostics at the bedside. After introduction of ultrasound in his practise, the success rate elevated from 40 to 90 percent during interventional procedural guidance."

Recently, Dr. Dureja began teaching a course on ‘Ultrasound-Guided Pain Interventions for Upper & Lower Limbs’ at his Delhi Pain Management Centre. He believes that ultrasound should be accessible to all physicians in their practise, as it is an ideal screening tool, and well suited to efficient procedural work with higher safety rates.

Dr. Dureja endorses the Sonosite SII ultrasound system & advocates Sonosite products for their intuitive interface, reliable build, and 5-year warranty.