RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd
SP rapm-2021-103004
DO 10.1136/rapm-2021-103004
A1 James Simeon Bowness
A1 Amit Pawa
A1 Lloyd Turbitt
A1 Boyne Bellew
A1 Nigel Bedforth
A1 David Burckett-St Laurent
A1 Alain Delbos
A1 Nabil Elkassabany
A1 Jenny Ferry
A1 Ben Fox
A1 James L H French
A1 Calum Grant
A1 Ashwani Gupta
A1 William Harrop-Griffiths
A1 Nat Haslam
A1 Helen Higham
A1 Rosemary Hogg
A1 David F Johnston
A1 Rachel Joyce Kearns
A1 Sandra Kopp
A1 Clara Lobo
A1 Sonya McKinlay
A1 Stavros Memtsoudis
A1 Peter Merjavy
A1 Eleni Moka
A1 Madan Narayanan
A1 Samer Narouze
A1 J Alison Noble
A1 David Phillips
A1 Meg Rosenblatt
A1 Amy Sadler
A1 Maria Paz Sebastian
A1 Alasdair Taylor
A1 Athmaja Thottungal
A1 Luis Fernando Valdés-Vilches
A1 Thomas Volk
A1 Simeon West
A1 Morné Wolmarans
A1 Jonathan Womack
A1 Alan James Robert Macfarlane
YR 2021
UL http://rapm.bmj.com/content/early/2021/09/22/rapm-2021-103004.abstract
AB 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.