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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…

Ultrasound-Guided Saphenous Nerve Block

Lower Extremity

Figure 1: Needle insertion to block the saphenous nerve at the level of the mid thigh (left) or below the knee (right). Essentials  Indications: saphenous vein stripping or harvesting, supplementation for medial foot/ankle surgery in combination    with a sciatic nerve…

Ultrasound-Guided Forearm Block

Upper Extremity

A B C Figure 1: (A) Radial nerve block above the elbow. The needle is inserted in-plane from lateral to medial direction. (B) Median nerve block at the level of the midforearm. (C) Ulnar nerve block at the level of…

Ultrasound-Guided Wrist Block

Upper Extremity

A B C Figure 1: Ultrasound-guided wrist block. Transducer and needle positions for (A) Median nerve block, (B) Ulnar nerve block, (C) Radial nerve block. Essentials  Indications: surgery on the hand and fingers  Transducer position: transverse at wrist crease or…

Bier Block

Intravenous Regional Anesthesia

Figure 1: Intravenous regional anesthesia: Injection of local anesthetic and placement of the tourniquet. Essentials Indications: short operative procedures for the extremities; pain therapy (e.g., treatment of recurrent complexpain    syndrome); treatment of hyperhidrosis Local anesthetic: 12-15 mL of 2% lidocaine…

Intercostal Block


Figure 1: Intercostal nerve block: Patient position and needle insertion. Essentials Indications: thoracic or upper abdominal surgery, rib fractures, breast surgery Landmarks: angle of the rib (6-8 cm lateral to the spinous process) Needle insertion: Under the rib with approximately…

Ultrasound Guided Ankle Block

Lower Extremity

Figure 1: Block of the posterior tibial nerve using an out-of-plane technique. Essentials  Indications: surgery on the foot and toes  Transducer position: about the ankle and depends on the nerve to be blocked  Goal: local anesthetic spread surrounding each individual…

Toxicity of Local Anesthetics

Foundations of Regional Anesthesia, General

AUTHORS: Steven Dewaele, Alan C. Santos Introduction Systemic toxicity of local anesthetics can occur after administration of an excessive dose, with rapid absorption, or because of an accidental intravenous injection. The management of local anesthetic toxicity can be challenging, and…

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