Key Points Prepuncture ultrasound scanning is helpful to determine the midline, the depth from the skin, the desired level, and rotation of the spine. There are limited outcome data on the real-time guidance with ultrasound for neuraxial blocks. The available…
Key Points The transversus abdominis plane (TAP) block is a tissue plane block depending on adequate spread of local anesthetics through the plane—accordingly a minimum volume of 20 mL is usually needed for effective block. Frequent, small, incremental injections of…
Key Points Serratus anterior block is indicated for anterolateral chest wall incisions, targeting the lateral and postcutaneous branches of upper and middle thoracic dermatomes. The block has been used for different thoracoscopic and open chest wall incisions as well as…
Key Points Anterior chest wall blocks are used as alternatives to thoracic epidurals and paravertebral blocks for breast surgeries and procedures involving the anterior chest walls. Serratus plane blocks and supraclavicular blocks may be required for more extensive surgeries. Pectoralis…
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…
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…
Equipment Needles, catheters, and syringes Effective regional anesthesia requires comprehensive knowledge of equipment—that is, the needles, syringes, and catheters that allow the anesthetic to be injected into the desired area. In early years, regional anesthesia found many variations in the…