ANTERIOR SCIATIC
I think that this is the first nerve block that I have introduced on this website where I will not say “this is an easy block that you should start on early in your course of learning ultrasound nerve blocks”. Again, it will certainly come to you, but it is not the easiest.. read more →
Tourniquet Issues #2
STYLE POINTS for Intercostobrachial Nerve Block I have mentioned elsewhere the need to cover the tourniquet site for an optimum effect. One of those sites is the inner upper arm for a tourniquet used for elbow, wrist and hand cases. This single shot block is usually used in combination with a supraclavicular or infraclavicular.. read more →
Total Shoulder, Bad Lungs
NOT MY USUAL STRATEGY I’ve mentioned elsewhere on this site that I have successfully taken care of many patients with this particular scenario, even those who are ‘oxygen-dependent’. The basic dilemma is whether to offer an interscalene block to someone that may have respiratory embarrassment due to spread to the phrenic nerve, knowing that without.. read more →
Tourniquet Issues
Many times, a quality nerve block could be considered a ‘failure’ or the anesthetic plan has to be altered because the use of or the exact position of the tourniquet was not considered. You KNEW the case warranted a nerve block or a continuous nerve block, and you knew the appropriate nerves to block.. read more →
Analgesia for Ex Lap
What do you do for analgesia for your Ex Lap cases? Typical responses that I get are ‘nothing’ or ‘sometimes an epidural.’ Have you ever followed their post-op experience? If you don’t put in an epidural, I’m sure you probably don’t end up doing that. In the past, those have been MY responses... read more →
Back on their Feet Again
Tip of the Iceberg I have indicated on this website multiple times and in multiple ways that the superior post-operative analgesia provided by continuous nerve blocks has significant benefits. Patients can leave the hospital faster and more comfortable and with fewer side-effects from opioids. I would like to point out that they have.. read more →
Sartorius Muscle
SARTORIUS: FRIEND OR FOE? Sounds like a silly title, but it does describe how I feel about that muscle sometimes when I am performing a continuous block for a Femoral, Fascia Iliaca or Saphenous nerve block. I described last week how the Sartorius Muscle can frustrate your attempts at a Fascia Iliaca block... read more →
Fascia Iliaca Tips
THE TRIANGLE If there is a sweet spot for the Fascia Iliaca block, it is ‘The Triangle”. That’s what I have come to call it, anyway. This is not the ‘Femoral Triangle’ you were taught in medical school … REGISTER for FREE to become a SUBSCRIBER or LOGIN HERE to see the.. read more →
CPNB for AKA
I have done continuous blocks in the past for post-operative analgesia (and to mitigate the risks of persistent pain and phantom pain and a multitude of other potential benefits) for amputations and as the primary anesthetic for foot amputations and BKA’s many times in the past. I have more consistently been performing CPNB’s.. read more →
Block Evaluation 3
WELCOME BACK! I have made a number of observations and recognized a number of patterns over the last several years working with nerve block patients. Here’s another I’d like to share. A point that I’ve made a dozen times in lecturing is that as you change or add techniques or processes, do so.. read more →