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BioMed Research International
Volume 2014, Article ID 920538, 5 pages
Clinical Study

A Standardized Method for 4D Ultrasound-Guided Peripheral Nerve Blockade and Catheter Placement

1Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
2Department of Anesthesiology, Mayo Clinic, 4500 San Pablo Boulevard, Jacksonville, FL 32224, USA

Received 1 May 2013; Revised 24 October 2013; Accepted 7 November 2013; Published 19 January 2014

Academic Editor: Daniel Kendoff

Copyright © 2014 N. J. Clendenen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We present a standardized method for using four-dimensional ultrasound (4D US) guidance for peripheral nerve blocks. 4D US allows for needle tracking in multiple planes simultaneously and accurate measurement of the local anesthetic volume surrounding the nerve following injection. Additionally, the morphology and proximity of local anesthetic spread around the target nerve is clearly seen with the described technique. This method provides additional spatial information in real time compared to standard two-dimensional ultrasound.