Perspective The nerves blocked in the popliteal fossa—the tibial and peroneal nerves—are extensions of the sciatic nerve. The principal use of this block is for foot and ankle surgery. The addition of a saphenous nerve block improves comfort, because medial…
Key Points The success of the block depends on the appropriate spread of local anesthetics in the appropriate fascial planes superficially and deeply to the adductor brevis muscle. Care should be taken to confirm the spread in the intermuscular fascial…
Key Points This block can be used to provide postoperative analgesia following hip surgery, upper lateral thigh skin grafting, and neurolysis for refractory meralgia paresthetica. Combined with other lower extremity blocks, it reduces the discomfort from the tourniquet during procedures…
Key Points A high-frequency linear transducer is preferred for this block. The fascia iliaca compartmental block (FICB) can be used as an alternative anterior approach to the lumbar plexus block, targeting the femoral, obturator, and lateral femoral cutaneous nerves. The…
Perspective This block is useful for surgical procedures carried out on the anterior thigh, both superficial and deep. It is most frequently combined with other lower extremity peripheral blocks to provide anesthesia for operations on the lower leg and foot.…
Perspective The sciatic nerve is one of the largest nerve trunks in the body, yet few surgical procedures can be performed with sciatic block alone. It is combined most often with femoral, lateral femoral cutaneous, or an obturator nerve block.…
Inguinal perivascular block (three-in-one block) Perspective The inguinal perivascular block is based on the concept of injecting local anesthetic near the femoral nerve in an amount sufficient to track proximally along fascial planes to anesthetize the lumbar plexus. The three…
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Key points Intravenous (IV) regional anesthesia is usually achieved using dilute lidocaine 0.5%; 50 mL of prilocaine has also been used successfully. The IV regional block is useful for procedures lasting 90–120 minutes. This time limit is due to tourniquet…
Key points Blockade of peripheral nerves of the upper extremity is often accomplished by brachial plexus approaches. However, conditions such as infections to brachial plexus sites, coagulopathy, single nerve distribution, minor procedures (not requiring a tourniquet), and rescue supplementations of…