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Single or Multiple Guidance Methods for Peripheral Nerve Blockade in Modern-Day Practice of Regional Anesthesia

      Regional anesthesia has traditionally been performed with the help of a single modality, which has depended on the availability of technology at the time of performance of these blocks. The transitions from paresthesia-guided to nerve stimulation to ultrasound-guided nerve blocks have helped advance regional anesthesia as a science rather than an art, and have taken it to a higher level of sophistication. However, the visual information obtained with the use of ultrasonography remains subject to interpretation by the user and, consequently, is limited by the ability to optimize the sonographic image, variations in formal training of applied ultrasound physics, and overall experience in ultrasonography. Even though ultrasound visualization by itself is presumably associated with minimal risks, the safety claimed by ultrasound enthusiasts may not necessarily result in the safest clinical practice.
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