Fascial plane blocks in regional anaesthesia: how problematic is simplification?

Introduction of ultrasound guidance into the clinical practice of regional anaesthesia was revolutionary and brought the potential for superior efficacy and safety compared with pre-ultrasound practice. Fulfilling this potential demands acquisition of new knowledge (sonographic anatomy and physical principles of ultrasound) and technical skills. The transition of non-neuraxial regional anaesthesia from a ‘hit or miss’ approach to a precision image-guided approach has led to an increasingly important role in perioperative medicine. The strength of ultrasound-guided techniques in experienced hands is that local anaesthetics can be administered as close as possible to nerve structures while damage to the nerve and adjacent anatomical structures can be avoided. The fact that so many anaesthesiologists around the world have undertaken the necessary learning and training to expand their clinical repertoire to encompass ultrasound-guided regional anaesthesia represents a real triumph for our specialty.