INFRACLAVICULAR
As I have mentioned in other places on this website, I have traditionally been more of a supraclavicular than an infraclavicular block fan. A recent conversation (rather, a friendly argument) gave me enough pause to look again at this technique. I will cut to the chase and say that I still have no good.. read more →
Questions about Upper Extremity Blocks Answered
The following dialogue was generated through the CPNBconsulting.com website. This was initiated by a regional anesthesia enthusiast in Bangalore, India who had some questions for Dr Jones on upper extremity nerve blocks. Dear Sir, I had a few queries to clear from you: 1. Why after a supraclavicular block, are patients still be able.. read more →
TAP Block Pain Evaluation
WHERE are you hurting??? It is critically important that you evaluate closely the location (and quality) of your patient’s pain before recommending changes in therapy or deciding whether your TAP or Subcostal TAP block is functioning properly. Without proper evaluation (and elucidating in the chart or face to face), your block may be.. read more →
Recognizing Appropriate Fascia Iliaca Spread: Watch this Video!
There is NO Doubt! This fascia iliaca video shows several key ultrasound cues that should always lead you to a successful nerve block. After the needle is advanced in a cranial direction, the initial injection reveals a very thin distribution of local anesthetic which does not inject easily (noted by assistant). Further, upon this injection,.. read more →
Fascia Iliaca Tips #2
THE SPREAD Usually, the Fascia Iliaca and Fascia Lata are clearly identifiable next to the thinner and less echogenic muscle fibers of the Sartorius and Iliopsoas muscles. There are times, however, when the deeper border of the Sartorius muscle blends in well or the exact position of the tip of your needle is difficult to.. read more →
PARAVERTEBRAL
This is not a block that you should cut your teeth on, but it is the one that, in my opinion, has the most dramatic impact on the recovery of my patients. It is just awesome to speak to a patient after a thoracotomy that can take a deep breath and cough easily.. read more →
LUMBAR PLEXUS
I find this block to be one of the few, whether single injection or continuous, where the impact of ultrasound utilization is not as dramatic an improvement as it is with most other nerve blocks. This comes from a few different variables. One, it is usually a deep block, so visualization of structures.. read more →