The safe and successful performance of ultrasound-guided regional anaesthesia (USGRA) requires both a detailed knowledge of the anatomy and sonoanatomy relevant to the block, and the ability to appreciate where the needle tip is at all times. The latter is dependent on skilful needle and transducer manipulation and can be the most challenging aspect of USGRA, particularly for novices. Visualising the needle tip on ultrasound requires that it be aligned with the ultrasound beam; however even when alignment is achieved, the physical characteristics of the needle and the limitations of ultrasound technology may hinder visibility. This article describes several strategies for needle and transducer manipulation designed to assist the practitioner with locating the needle tip and guiding it to the desired target.
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Ki Jinn Chin (2010) studied this question.
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