One of the interns did this fantastic block. There are lots of examples of good technique here.

• Notice how the needle is kept parallel to the transducer (perpendicular to beam). That’s why the image is so sharp.
• Notice how she got the needle tip into the facial plane, then you see the planes being spread by the lidocaine to deposit the anesthetic into the potential space where the nerve sits.
• Once she spread apart the fascial planes, notice how she puts the needle above and then below the nerve until she gets circumferential spread around it.
• Several times, the needle goes out of the image, but she nicely makes a subtle adjustment and brings the tip back into the image.
• At the 27 second mark, the needle tip is against the nerve. In order to get the tip to move upward, the needle is retracted slightly and redirected upward.

Forearm blocks of the median, radial, and ulnar nerves are a great place to dip your toe into the waters of ultrasound guided regional anesthesia. I highly recommend getting comfortable with these. Once you have the technique down, there’s nothing stopping you from progressing to blocks that involve more complicated anatomy.