Minimize ambient light to improve image quality. Placing a spot on the block site and darkening the rest of the room can have a dramatic effect on the ultrasound image.

Due to the potentially lethal complications of large doses of local anesthetic, ipsilateral diaphragm paralysis or inadvertent intravascular injection, conventional teaching includes placing the patient on a cardiac monitor, establishing IV access and having emergency airway equipment available. For patients with respiratory issues, consider placing oxygen and using capnometry. Provide analgesics and light sedation as needed.