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Obturator Nerve Block

Lower Extermity

Obturator nerve block is used to treat hip joint pain and in the relief of adductor muscle spasm associated with hemi-or paraplegia. Muscle spasticity is relatively common problem among patients suffering from central neurological problems such as cerebrovascular pathology, medullar injuries, multiple sclerosis, infantile cerebral palsy, etc.

Caudal Anesthesia

Landmark Based

Caudal anesthesia was first described at the turn of last century by two French physicians, Fernand Cathelin and Jean-Anthanase Sicard. The technique predated the lumbar approach to epidural block by several years. By Kenneth D. Candido, MD and Alon Winnie,…

Continuous Thoracic Paravertebral Block


Overview  Indications: Breast surgery, pain management after thoracic surgery or rib fractures  Landmarks:                      Spinal process at the desired thoracic dermatomal levels                      Needle insertion: 2.5 cm lateral to midline  Target goal: needle insertion 1 cm past the transverse process  Local anesthetic:…

Thoraco Lumbar Paravertebral Block

Landmark Based

Overview  Indications: Inguinal hernia surgery, lateral abdominal wall surgery  Landmarks:                      Spinal processes T9-L5 (the number and location of levels chosen for each indication)                      Transverse process  Needle insertion: 2 cm lateral to midline  Target goal: Needle insertion 1 cm past the…

Monitoring and Documentation

Foundations of Regional Anesthesia

AUTHOR: Jeff Gadsden Introduction The incidence of complications from general anesthesia has diminished substantially in recent decades, largely due to advances in respiratory monitoring. (1) The use of objective monitors such as pulse oximetry and capnography allows anesthesiologists to quickly…

Indications for Peripheral Nerve Blocks

Foundations of Regional Anesthesia

AUTHOR: Jeff Gadsden Introduction During the past 20 years, increasing knowledge in functional regional anesthesia anatomy, coupled with new technologies for locating peripheral nerves, has resulted in expansion of regional anesthesia techniques. This phenomenon served to provide the clinician with…

Ultrasound Guided Femoral Nerve Block

Lower Extremity

Figure 1: Transducer position and needle insertion using an in-plane technique to block the femoral nerve at the femoral crease. Essentials  Indications: anterior thigh, femur, and knee surgery  Transducer position: transverse, close to the femoral crease  Goal: local anesthetic spread…

Ultrasound-Guided Fascia Iliaca Block

Lower Extremity

Figure 1: Needle insertion for the fascia iliaca block. The black dot indicates the position of the femoral artery. Essentials  Indications: anterior thigh and knee surgery, analgesia following hip and knee procedures  Transducer position: transverse, close to the femoral crease…

Ultrasound Guided Obturator Nerve Block

Lower Extremity

Figure 1: Needle insertion using an in-plane technique to accomplish an obturator nerve block. Essentials  Indications: Relief of painful adductor muscle contractions, top revent adduction of thigh during transurethral    bladder surgery, additional analgesia after major knee surgery  Transducer position: Medial…

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