Block Tray Set-Up

A thorough and ergonomically prepared regional block tray is a prerequisite for successful and time-efficient administration of regional blocks. Unless the operator has all equipment prepared and ready to use, the performance of regional blocks will be quite laborious. Regional anesthesia trays can obviously be set-up in many different ways, to accommodate local practice settings and commonly used techniques. However, here we just suggest a basic setup which is quick to prepare and works very well in our practice.

A thorough and ergonomically prepared regional block tray is a prerequisite for successful and time-efficient administration of regional blocks. Unless the operator has all equipment prepared and ready to use, the performance of regional blocks will be quite laborious. Regional anesthesia trays can obviously be set-up in many different ways, to accommodate local practice settings and commonly used techniques. However, here we just suggest a basic setup which is quick to prepare and works very well in our practice.

We routinely use a small instrument tray (1). First, we open a pack of sterile surgical towels (2) and drape the tray. Then, we simply add and arrange the following equipment on the tray:

Sterile gloves Sterile 4 x 4 gauze Three 20 ml syringes for local anesthetic A skin marker with a ruler Electrode for nerve stimulator Insulated nerve stimulator needle of desired length A 25G 1½ inch needle for skin infiltration Optional injection pressure monitor

While this is a common setup for a nerve stimulator assisted nerve block, other equipment that is used with various blocks may be simply added. These may include stopcocks, various block needles, control syringes, extension tubing etc. The setup is not complete without nerve stimulator, syringes for premeditation and solution for skin preparation, which we keep off the tray.

Needle Sizes For Peripheral Nerve Blocks

Choose the needle of appropriate size for each and every block technique!

A needle that is too short will obviously not reach its targeted depth, whereas a needle of excessive length is much more difficult to control during advancement. In addition, excessively long needles tend to be inserted too far and, possibly resulting in serious complications. The recommendations in the table bellow are general recommendations only and they apply to nerve block techniques practiced at our institution and featured on NYSORA.