RT Journal Article SR Electronic 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 FD BMJ Publishing Group Ltd SP rapm-2022-103738 DO 10.1136/rapm-2022-103738 A1 Toby Ashken A1 James Bowness A1 Alan James Robert Macfarlane A1 Lloyd Turbitt A1 Boyne Bellew A1 Nigel Bedforth A1 David Burckett-St Laurent A1 Alain Delbos A1 Kariem El-Boghdadly A1 Nabil M Elkassabany A1 Jenny Ferry A1 Ben Fox A1 James L H French A1 Calum Grant A1 Ashwani Gupta A1 Rajnish K Gupta A1 Yavuz Gürkan A1 Nat Haslam A1 Helen Higham A1 Rosemary M G Hogg A1 David F Johnston A1 Rachel Joyce Kearns A1 Clara Lobo A1 Sonya McKinlay A1 Edward R Mariano A1 Stavros Memtsoudis A1 Peter Merjavy A1 Madan Narayanan A1 J Alison Noble A1 David Phillips A1 Meg Rosenblatt A1 Amy Sadler A1 Maria Paz Sebastian A1 Eric S Schwenk A1 Alasdair Taylor A1 Athmaja Thottungal A1 Luis Fernando Valdés-Vilches A1 Thomas Volk A1 Simeon West A1 Morné Wolmarans A1 Jonathan Womack A1 Amit Pawa YR 2022 UL http://rapm.bmj.com/content/early/2022/09/05/rapm-2022-103738.abstract AB 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.