TY - JOUR T1 - International consensus on anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia JF - Regional Anesthesia & Pain Medicine JO - Reg Anesth Pain Med DO - 10.1136/rapm-2021-103004 SP - rapm-2021-103004 AU - James Simeon Bowness AU - Amit Pawa AU - Lloyd Turbitt AU - Boyne Bellew AU - Nigel Bedforth AU - David Burckett-St Laurent AU - Alain Delbos AU - Nabil Elkassabany AU - Jenny Ferry AU - Ben Fox AU - James L H French AU - Calum Grant AU - Ashwani Gupta AU - William Harrop-Griffiths AU - Nat Haslam AU - Helen Higham AU - Rosemary Hogg AU - David F Johnston AU - Rachel Joyce Kearns AU - Sandra Kopp AU - Clara Lobo AU - Sonya McKinlay AU - Stavros Memtsoudis AU - Peter Merjavy AU - Eleni Moka AU - Madan Narayanan AU - Samer Narouze AU - J Alison Noble AU - David Phillips AU - Meg Rosenblatt AU - Amy Sadler AU - Maria Paz Sebastian AU - Alasdair Taylor AU - Athmaja Thottungal AU - Luis Fernando Valdés-Vilches AU - Thomas Volk AU - Simeon West AU - Morné Wolmarans AU - Jonathan Womack AU - Alan James Robert Macfarlane Y1 - 2021/09/22 UR - http://rapm.bmj.com/content/early/2021/09/22/rapm-2021-103004.abstract N2 - There is no universally agreed set of anatomical structures that must be identified on ultrasound for the performance of ultrasound-guided regional anesthesia (UGRA) techniques. This study aimed to produce standardized recommendations for core (minimum) structures to identify during seven basic blocks. An international consensus was sought through a modified Delphi process. A long-list of anatomical structures was refined through serial review by key opinion leaders in UGRA. All rounds were conducted remotely and anonymously to facilitate equal contribution of each participant. Blocks were considered twice in each round: for “orientation scanning” (the dynamic process of acquiring the final view) and for the “block view” (which visualizes the block site and is maintained for needle insertion/injection). Strong recommendations for inclusion were made if ≥75% of participants rated a structure as “definitely include” in any round. Weak recommendations were made if >50% of participants rated a structure as “definitely include” or “probably include” for all rounds (but the criterion for “strong recommendation” was never met). Thirty-six participants (94.7%) completed all rounds. 128 structures were reviewed; a “strong recommendation” is made for 35 structures on orientation scanning and 28 for the block view. A “weak recommendation” is made for 36 and 20 structures, respectively. This study provides recommendations on the core (minimum) set of anatomical structures to identify during ultrasound scanning for seven basic blocks in UGRA. They are intended to support consistent practice, empower non-experts using basic UGRA techniques, and standardize teaching and research. ER -