Atlas of Ultrasound-Guided Regional Anesthesia: A Comprehensive Visual Guide to Peripheral Nerve Blocks and Fascial Plane Techniques from Fundamentals to Advanced Practice

Ultrasound-guided regional anesthesia has transformed the practice of pain management and perioperative care. The ability to visualize nerve targets, confirm local anesthetic spread, and navigate safely around vascular structures in real time has made blocks safer, more precise, and more reliably effective than any preceding era of regional technique. Mastering this discipline requires both a deep understanding of sonographic physics and anatomy and a systematic, technique-level command of every major block. This atlas was written to develop both. The Atlas of Ultrasound-Guided Regional Anesthesia is a comprehensive illustrated reference covering the complete spectrum of ultrasound-guided peripheral nerve blocks and fascial plane techniques from foundational principles through advanced and emerging practice. It is written for anesthesiology residents, regional anesthesia fellows, practicing anesthesiologists, certified registered nurse anesthetists, and pain medicine specialists who perform or are developing competency in ultrasound-guided regional techniques. The atlas opens with eleven foundational chapters covering the physics of ultrasound from sound wave generation through clinical image formation, attenuation, reflection, and acoustic artifacts, anisotropy and spatial compound imaging, Doppler imaging in regional anesthesia, transducer selection and optimization, needle imaging and echogenicity, sonographic signs of successful local anesthetic injection and spread, patient setup and scanning protocols, in-plane and out-of-plane needle approaches, continuous peripheral nerve block catheter placement, and three-dimensional and ultra-high-frequency ultrasound. Six sonoanatomy chapters follow covering systematic approaches to nerve identification and characterization, muscle and fascial plane recognition, vascular structure identification and safe navigation, and sonoanatomic variants and clinical pitfalls across all regions. Block technique chapters are organized by anatomical region. Upper extremity blocks cover interscalene and superior trunk blocks, supraclavicular and suprascapular nerve blocks, infraclavicular and axillary blocks, forearm nerve blocks of the radial, median, and ulnar nerves, wrist and hand blocks, musculocutaneous nerve block, continuous upper extremity catheter techniques, and block selection and complication management. Lower extremity blocks cover the femoral nerve block, adductor canal block and quadriceps-sparing strategy, obturator nerve block and fascia iliaca block, PENG block, genicular and iPACK blocks for hip and knee analgesia, sciatic nerve block by subgluteal, anterior, and popliteal approaches, lateral and posterior femoral cutaneous nerve blocks, saphenous nerve block, and complete five-nerve ankle block. Trunk blocks cover all transversus abdominis plane block approaches, rectus sheath, ilioinguinal and iliohypogastric nerve blocks, serratus anterior plane and PECS blocks, intercostal and transversus thoracis blocks, erector spinae plane block, thoracic paravertebral block, and quadratus lumborum blocks across lateral, posterior, and anterior approaches. Head, neck, and neuraxial chapters cover head and face nerve blocks, cervical plexus, maxillary, and airway blocks, greater occipital nerve block, stellate ganglion block, neuraxial ultrasound guidance for spinal and epidural procedures, and caudal epidural block. A dedicated complication prevention and management chapter covers local anesthetic systemic toxicity, pneumothorax, vascular injury, nerve injury, and intravascular injection recognition and response. Final chapters address artificial intelligence in ultrasound-guided regional anesthesia, simulation. Back matter includes a glossary, local anesthetic pharmacology and dosing quick reference, ASRA LAST management protocol, block selection by surgical procedure table, and an ultrasound machine optimization checklist.