In plane vs out of plane technique – which one to choose?


Posted February 19, 2013 by tedmark

The in plane vs out of plane techniques are disputed all over the world. But which one should you choose in ultrasound guided blocks?

 
As a young anesthesiologist you know that you need to take a lot of important decisions during your career and the use of in plane and out of plane technique will be just one of them. The in plane vs out of plane techniques have been disputed by many doctors that have gathered both the advantages and disadvantages of these techniques, but no one can tell for sure which technique is the best to use. You just have to read a lot about these techniques and about block techniques to be able to decide which one you should use.

The in plane vs out of plane techniques are used in performing different block techniques and some anesthesiologists can use the in plane technique for a certain block while other anesthesiologists find the out of plane technique much easier to be used for the same block. For the adductor canal block, for example, many anesthesiologists use the out of plane technique. The out of plane technique has the advantage that you can see the tip of the needle much easier than in the case of the in plane technique.

The adductor canal block is a common technique used in total knee arthroplasty, which is a procedure that is associated with postoperative pain that the patient cannot bear without postoperative analgesia. Besides the adductor canal block, that minimizes the side effects and increases mobilization of the knee, good surgery analgesia is also the femoral block that can be combined with the obturator block. But no matter which block you choose to use, you need to decide which needle alignment you should use for any ultrasound-guided regional anesthesia that you have to perform at a certain point.

The in plane vs out of plane difficulties should guide you when choosing one of these techniques. Because you need precision when you perform a technique, you need to see the tip of the needle. Even though you can see the tip of the needle by using both the in plane technique and out of plane, you will have less artifact using the out of plane technique. If you need to see the whole needle during a block procedure than you should use the in plane technique.

It is very important to take the right decision when performing block techniques for the best results, and that is why you should analyze your options before performing the technique. In the beginning it will be more difficult to choose the needle alignment technique, but a good option would be to analyze well the block procedures and see if you should use the in plane or out of plane technique by putting into balance the advantages and disadvantages of each block technique. You can find in the bibliography the best needle alignment technique for each block and this can be the best start.

For the adductor canal block http://www.ultrasoundblock.com/index.php/nerve-block-techniques/new-blocks/adductor-canal-block many anesthesiologists use the out of plane technique. The in plane vs out of plane http://www.ultrasoundblock.com/index.php/nerve-block-controversies/nerve-block-in-plane-vs-out-of-plane-techniques techniques have been disputed by many doctors.
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Issued By tedmark
Country United Kingdom
Categories Health
Tags adductor canal block , in plane vs out of plane
Last Updated February 19, 2013