The use of high-intensity focused ultrasound as a novel treatment for painful conditions—a description and narrative review of the literature M.R.D.

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Presentation transcript:

The use of high-intensity focused ultrasound as a novel treatment for painful conditions—a description and narrative review of the literature M.R.D. Brown, P. Farquhar-Smith, J.E. Williams, G. ter Haar, N.M. deSouza British Journal of Anaesthesia Volume 115, Issue 4, Pages 520-530 (October 2015) DOI: 10.1093/bja/aev302 Copyright © 2015 The Author(s) Terms and Conditions

Fig 1 Diagram showing the extracorporeal generation of HIFU and its use to form a thermal lesion within a tissue target. British Journal of Anaesthesia 2015 115, 520-530DOI: (10.1093/bja/aev302) Copyright © 2015 The Author(s) Terms and Conditions

Fig 2 (a) MRI scanner with HIFU transducer located in patient table (*). (b) Planning scans allow a sonication matrix to be accurately targeted prior to treatment. (c) Real-time MRI thermometry displays tissue temperatures during treatment, providing confirmation of the sonication site. British Journal of Anaesthesia 2015 115, 520-530DOI: (10.1093/bja/aev302) Copyright © 2015 The Author(s) Terms and Conditions

Fig 3 Postulated mechanisms through which HIFU exerts its analgesic effects. (a) Localised tissue heating causes thermal damage to unmyelinated nociceptive fibres present close to the painful target. (b) Mechanical effects on the neuronal membrane and cytoskeleton activate stretch-sensitive ion channels and create membrane defects that alter membrane potential, (c) leading to changes in neuronal excitability, action potential propagation and ultimately nerve function. British Journal of Anaesthesia 2015 115, 520-530DOI: (10.1093/bja/aev302) Copyright © 2015 The Author(s) Terms and Conditions