Rationale For Use of Lower Extremity Conduction Nerve Blocks

Principles of selection of a lower extremity nerve block

For many surgical procedures, a single shot nerve block is appropriate both in terms of duration of analgesia and morbidity.[15-17] The most commonly used local anesthetics are displayed in the table below. Most single shot lower extremity nerve blocks procedures are also applicable to day case surgery patients. Partial motor blockade does not prevent hospital discharge provided that the parents are insightful and well informed, although the ambulation may not be possible. How-ever, if there is a potential risk of developing a compartment syndrome, it would be preferable to monitor the patient adequately on the ward and delay hospital discharge until complete recovery, or avoid the nerve blocks altogether.











a: Maximum doses are hypothetical and subjective; toxicity results from peak plasma concentration of the free unbound form, not from the total dose injected; the maximum doses mentioned in this table are safe when given as single injections, whereas they might be or might not be safe following multiple previous injections (or continuous infusion), especially with long-lasting local anesthetics (bupivacaine and probably too, ropivacaine and levobupivacaine).
b: May last more than 12, even 18, hours following certain block procedures (sciatic nerve block especially).