TY - JOUR T1 - Recommendations for anatomical structures to identify on ultrasound for the performance of intermediate and advanced blocks in ultrasound-guided regional anesthesia JF - Regional Anesthesia & Pain Medicine JO - Reg Anesth Pain Med DO - 10.1136/rapm-2022-103738 SP - rapm-2022-103738 AU - Toby Ashken AU - James Bowness AU - Alan James Robert Macfarlane AU - Lloyd Turbitt AU - Boyne Bellew AU - Nigel Bedforth AU - David Burckett-St Laurent AU - Alain Delbos AU - Kariem El-Boghdadly AU - Nabil M Elkassabany AU - Jenny Ferry AU - Ben Fox AU - James L H French AU - Calum Grant AU - Ashwani Gupta AU - Rajnish K Gupta AU - Yavuz Gürkan AU - Nat Haslam AU - Helen Higham AU - Rosemary M G Hogg AU - David F Johnston AU - Rachel Joyce Kearns AU - Clara Lobo AU - Sonya McKinlay AU - Edward R Mariano AU - Stavros Memtsoudis AU - Peter Merjavy AU - Madan Narayanan AU - J Alison Noble AU - David Phillips AU - Meg Rosenblatt AU - Amy Sadler AU - Maria Paz Sebastian AU - Eric S Schwenk AU - Alasdair Taylor AU - Athmaja Thottungal AU - Luis Fernando Valdés-Vilches AU - Thomas Volk AU - Simeon West AU - Morné Wolmarans AU - Jonathan Womack AU - Amit Pawa Y1 - 2022/09/05 UR - http://rapm.bmj.com/content/early/2022/09/05/rapm-2022-103738.abstract N2 - Recent recommendations describe a set of core anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia (UGRA). This project aimed to generate consensus recommendations for core structures to identify during the performance of intermediate and advanced blocks. An initial longlist of structures was refined by an international panel of key opinion leaders in UGRA over a three-round Delphi process. All rounds were conducted virtually and anonymously. Blocks were considered twice in each round: for “orientation scanning” (the dynamic process of acquiring the final view) and for “block view” (which visualizes the block site and is maintained for needle insertion/injection). A “strong recommendation” was made if ≥75% of participants rated any structure as “definitely include” in any round. A “weak recommendation” was made if >50% of participants rated it as “definitely include” or “probably include” for all rounds, but the criterion for strong recommendation was never met. Structures which did not meet either criterion were excluded. Forty-one participants were invited and 40 accepted; 38 completed all three rounds. Participants considered the ultrasound scanning for 19 peripheral nerve blocks across all three rounds. Two hundred and seventy-four structures were reviewed for both orientation scanning and block view; a “strong recommendation” was made for 60 structures on orientation scanning and 44 on the block view. A “weak recommendation” was made for 107 and 62 structures, respectively. These recommendations are intended to help standardize teaching and research in UGRA and support widespread and consistent practice.All data relevant to the study are included in the article or uploaded as supplementary information. ER -