In my personal opinion, an in plane approach is better, since I believe keeping the whole needle in my visual field. I achieve this by keeping the needle in the beam of the ultrasound probe, using a curved probe. On the contrary in out plane approach, you see the needle tip only when it comes under the probe over targeted tissue.

For any ultrasound guided procedure, however, my advice would be to use the approach you are most familiar with.

Best regards.   

Aboud,

in-plane would be preferable without the concomitant use of nerve stimulation.

Regards,

Christopher

in-plane is my choice, it may be due to lack of experience. i feel out of the plane is much safer as needle will travel short distance but one has to be expert to locate the needle tip and recognize tissue distortion in absolutely correct manner.  

In-plane is almost universal (and safest), in my experience

The additional needle trauma is minimal

In-plane technique is easier, but for the placement of catheter for countinuous analgesia only out-of-plane approach or oblique view of the plexus with in-plane needle insertion are the methods of choice.

in piane is my choice

We prefer (and teach) mostly out-of-plane, because

- the distance from skin to nerve is shorter

- Easier access when patient is in supine position. When you do in-plane, you usually hit the mattress with your hand unless you turn the patient to a slightly lateral position

Best,

Oliver

In plane

I prefer In-Plane Technique: using an in-plane technique and a lateral to medial direction, care must be taken to visualize the entire length of the needle during the advancement process. Technical and patient factors can limit this approach.

I prefer in plane for precise deposition of drug and to avoid inadvertent complications.

I prefer in plano.