Background and Objectives: The presence of neurovascular abnormalities may increase the risk of complications following regional anesthesia techniques. Use of conventional nerve localization methods may fail to detect such abnormalities and potentially result in block failure and/or unintentional neurovascular injury.

Methods: We use 2 examples to illustrate this, and the concept that systematic use of a preprocedure ultrasound (US) scan may serve as an aid both for diagnosis of abnormal anatomy, and in planning the appropriate anesthetic technique.

Results: Use of a preprocedure US scan helped to diagnose abnormal anatomy and assisted in planning a more appropriate anesthetic technique.

Conclusions: We believe that a systematic sonographic survey prior to regional anesthesia can be a valuable bedside screening tool to assess the suitability and challenges involved in performing US-guided peripheral nerve block.