Editor-The lumbar plexus block (LPB) has been traditionally performed with the needle puncture guided by landmark and the injection point confirmed by nerve stimulator. Various ultrasound approaches could help improve the safety, but each has its own problems. Not until the advent of the 'Shamrock method' 1 did I routinely, perhaps more easily, apply ultrasound for real-time guidance during LPB. Personally, I recommend the 'Shamrock method' to be the standard of ultrasound monitoring for LPB in combination with pressure and stimulator monitoring, the so-called triple monitoring. Several advantages could be found while applying the 'Shamrock method' compared with others.Firstly, the 'Shamrock method' is the real needle in-plane one without changing the practice of traditional landmarkguided LPB, all the same besides additional information of needle trajectory. The lumbar plexus is almost always located ventral to the medial half of the transverse process on shamrock view. Although absolute posterior-anterior approach could also be accomplished and assisted by the famous 'trident sign', 2 most clinicians consider it an out-of-plane technique and hard to prevent inadvertent needle puncture during LPB, at least possible for the kidney 3 and intestines. Using the 'Shamrock method', the needle shaft usually could be found after slightly tilting the transducer. Personal experience revealed
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