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Jeez. One of the “ prehistoric” guys here. The use of the micro puncture needle and liberal use of fluoroscopy (to confirm landmarks ) and experience are enough for the vast majority of cases. Ultrasound guidance is helpful in those tough cases. You have to use Ultrasound routinely at first to train yourself but I can’t see using it every case will be cost or time effective. However, when the last of the old fossils go, guidelines will change , and you will need to use ultrasound on every case. Sigh.
