December 28, 2012
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     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

October 7, 2012
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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

September 28, 2012
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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 →

Arteries through C5

September 1, 2012

   Over and over again, I am reaffirmed of the of the ‘everyday advantages’ of utilizing ultrasound for peripheral nerve blocks. …   REGISTER for FREE to become a SUBSCRIBER or LOGIN HERE to see the full article!     read more →

Tourniquet Issues

July 18, 2012

   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

June 25, 2012
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     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

June 18, 2012
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    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

May 28, 2012
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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 →

Ultrasound Tip #3

May 14, 2012
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There are a number of ways that you can gain assistance in recognizing the tip of your needle while advancing it. Some are cheap, and some are expensive. I’m certainly not going to say that you should abandon all of the mechanisms that allow you to recognize the needle tip that are available if your.. read more →


April 30, 2012
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     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 →