The concept of body ergonomics in regional anesthesia refers to strategies used to optimize performance during a procedure.  The goal of using good ergonomics is to reduce or eliminate extraneous factors, such a muscular fatigue, allowing the provider to focus on the task.  Below are a few guidelines to consider:

  • Raise the bed height to a position that is comfortable.
  • Avoid bending over or twisting if possible.
  •  Arrange the U/S system so there is a direct line of visualization.
  • Support the scanning arm; this will help maintain a consistent image.
  • Reduce the amount of shoulder abduction with the scanning arm.

 If possible, have someone assist during the block.  Ultrasound is most effective when visualization of the needle is continuous throughout the procedure.  An assistant, who can make adjustments to the ultrasound image and inject the local anesthetic, will not only save time, but also reduce the potential for complications.

What Not to Do

Look at the above image. What are several things the anesthetist could do to improve the success rate of this block?


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