We agree that the use of ultrasound guidance is rapidly becoming the gold standard in regional anaesthesia [1]. When using electrical stimulators for peripheral nerve location, it has been common practice for the anaesthetist to inject the local anaesthetic while the assistant controls the nerve stimulator output. During ultrasound-guided nerve blockade, we have noticed that the anaesthetist uses one hand to control the ultrasound probe and the other to position the needle tip, and the assistant delivers the local anaesthetic solution. By handing over this task, the anaesthetist loses valuable feedback from the syringe plunger, since resistance to injection might indicate an intraneural needle tip position [2]. Moreover, in contrast to the nerve stimulation technique, where a single bolus injection is typical, with ultrasound-guided nerve blockade a number of smaller boluses are often given, as the needle tip is repositioned to optimise spread of local anaesthetic around nerves. Communicating and co-ordinating a number of smaller injections can be difficult and this is a potential source of error.
展开▼
