Transtracheal block provides topical anesthesia of small branches of the recurrent laryngeal nerve that lines the tracheal lumen below the vocal cords. Because transtracheal injection usually elicits a strong cough reflex, local anesthetic also will distribute over the walls of…
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Introduction In many patients, epidural and spinal blocks are routine procedures guided by loss of resistance and confirmation of free flow of cerebrospinal fluid, respectively. However, in patients with obesity or advanced age, these neuraxial blocks can be more challenging…
Introduction The pudendal nerve is the major paired nerve of the perineum. It supplies sensation to the genitalia and perineal skin, and motor innervation to the external anal and external urethral sphincters. It is a branch of the sacral plexus…
Introduction Thoracic paravertebral block (TPVB) is the technique of injecting local anesthetic alongside the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina. This produces ipsilateral somatic and sympathetic nerve blockade in multiple contiguous thoracic dermatomes…
Clinical Anatomy/Sonoanatomy The quadratus lumborum (QL) is a posterior abdominal wall muscle that lies dorsolateral to the psoas major (PM) muscle. The QL muscle originates from the inner lip of the medial half of the iliac crest and inserts into…
Anatomic Background The key to using transversus abdominis plane (TAP) blocks for abdominal surgery analgesia is a thorough understanding of the anatomy. The abdominal wall nerves from T7 to T9 emerge under the costal margin into the TAP and then…
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