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Needle Visualization in Ultrasound-Guided Regional Anesthesia: Challenges and Solutions
  1. Ki Jinn Chin, M.B.B.S., F.A.N.Z.C.A., M. Med., F.R.C.P.C.,
  2. Anahi Perlas, M.D., F.R.C.P.C.,
  3. Vincent W.S. Chan, M.D., F.R.C.P.C. and
  4. Richard Brull, M.D., F.R.C.P.C.
  1. Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada


Needle visualization is important for safe and successful ultrasound-guided peripheral nerve block. However, accurate and consistent visualization of the needle tip can be difficult to achieve. This review article describes many of the challenges affecting needle visualization, summarizes the relevant literature on ultrasound imaging of needles, and offers practical strategies for improving needle tip visibility. Finally, future directions for research and development are suggested.

  • Needle visualization
  • Peripheral nerve block
  • Regional anesthesia
  • Ultrasound

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  • Reprint requests: Richard Brull, M.D., F.R.C.P.C., Department of Anesthesia, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto M5T 2S8, Ontario, Canada. E-mail: richard.brull{at}