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Evidence-Based Medicine: Ultrasound Guidance for Truncal Blocks
  1. Matthew S. Abrahams, MD,
  2. Jean-Louis Horn, MD,
  3. L. Michele Noles, MD and
  4. Michael F. Aziz, MD
  1. From the Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR.
  1. Address correspondence to: Matthew S. Abrahams, MD, Department of Anesthesiology and Perioperative Medicine, 3181 SW Sam Jackson Park Rd, Oregon Health and Sciences University, Portland, OR 97239-3098, Mailcode UHS-2 (e-mail: abrahama{at}


We performed a systematic search of the medical literature and reviewed the evidence examining success rates and incidence of complications of ultrasound (US) guidance relative to traditional techniques for the following blocks: paravertebral, intercostal, transversus abdominis plane, rectus sheath, and ilioinguinal/iliohypogastric. We included studies of sufficient methodologic quality for review and excluded poor-quality studies. We then rated the strength of evidence for US guidance for each block using a system developed by the United States Agency for Health Care Policy and Research. Although relatively few studies have compared US guidance with established techniques, the available evidence suggests that the use of US guidance is a safe and effective means to facilitate correct needle placement and adequate spread of local anesthetic for truncal blocks. Further studies are needed to directly compare US guidance to traditional techniques and to clarify potential benefits and limitations of US guidance for truncal blocks.

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  • The authors have no conflicts of interest to declare.

  • This research was funded internally by the Department of Anesthesiology and Perioperative Medicine, Oregon Health and Sciences University. No outside funding was provided by any governmental, other public or private agency, or industrial entity.