Perspective This block is often used for surgical procedures carried out on the foot, especially for those not requiring high lower-leg tourniquet pressure. Patient Selection. The ankle block is principally an infiltration block and does not require elicitation of paresthesia.…
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…
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…
Perspective Axillary brachial plexus block is most effective for surgical procedures distal to the elbow. Some patients can undergo procedures on the elbow or lower humerus with an axillary technique, but strong consideration should be given to a supraclavicular block…
Perspective Supraclavicular block provides anesthesia of the entire upper extremity in the most consistent, efficient manner of any brachial plexus technique. It is the most effective block for all portions of the upper extremity and is carried out at the…