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The Endpoint Survey: An International Survey of Ultrasound Guided Regional Anaesthesia Needle-Tip Endpoints

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The Endpoint Survey:  An International Survey of Ultrasound Guided Regional Anaesthesia Endpoints. The Endpoint Survey.
Dr M Chazapis, Dr N Kaur, Dr S West, Dr D Kamming 

Background

Ultrasound guidance is rapidly becoming the gold standard for regional anaesthesia. There is an ever-growing body of evidence, matched with improving technology, to show that the use of ultrasound has significant benefits over conventional techniques, such as nerve stimulation and loss of resistance.

With ultrasound, nerve identification is facilitated, there is direct observation of surrounding structures (vessels, muscles, tendons), LA deposition and spread, decrease in complications such as accidental intraneural or intravascular injections, faster onset of blocks, longer duration of blocks, improved block quality, and decreased dose of local anaesthetic.

As ultrasound guided regional anaesthesia is becoming more prevalent, practitioners are moving away from the use of nerve stimulation, and concomitant nerve stimulation, to use purely ultrasound-guided techniques. Before, the appropriate muscle twitch was a predefined endpoint for acceptable needle positions. With purely ultrasound-guided techniques, there are no predefined endpoints. Indeed, there are lots of descriptions of nerve blocks under purely ultrasound guidance, but few descriptions of where to put the needle.

Our aim was to survey current practice of ultrasound guided regional anaesthesia; specifically, accepted needle endpoints for common blocks, using a bespoke interactive website.

This is a student project for the MSc of Regional Anaesthesia, University of East Anglia, United Kingdom

www.regionalendpoint.com

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