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Wrist Block

General, Upper Extermity

A B Figure 1: (A) Technique to accomplish a wrist block. (B) Median nerve block. Needle is inserted medial or lateral to the flexor palmaris longus tendon and carefully advanced to avoid paresthesia. Then 5 mL of local anesthetic is…

Cutaneous Nerve blocks of the Upper Extremity


A B C Figure 1: Techniques to block the cutaneous nerves of the upper extremity. Essentials Indications: mostly used as a supplement to major blocks of the upper extremity Local anesthetic: 5-10 mL General Considerations Cutaneous nerve blocks of the…

Sciatic Nerve Block: Transgluteal / Anterior Approach

Lower Extermity

A B Figure 1-1: (A) Needle insertion for the transgluteal (posterior) approach to sciatic nerve block. (B) Needle insertion for anterior sciatic block. Essentials Transgluteal (Posterior) Approach Indications: surgery on the knee, tibia, ankle, and foot Landmarks: greater trochanter, superior…

Femoral Nerve Block

Lower Extermity

Figure 1: Needle insertion for femoral nerve block. Essentials Indications: surgery of the anterior thigh and knee surgery Landmarks: femoral (inguinal) crease, femoral artery pulse Nerve stimulation: twitch of the patella (quadriceps) at 0.2-0.5 mA Local anesthetic: 15-20 mL Figure…

Ankle Block

Lower Extermity

Figure 1: Needle insertion for saphenous nerve block of the ankle. Essentials Indications: surgery of the foot and toes Two deep nerves: posterior tibial, deep peroneal Three superficial nerves: superficial peroneal, sural, saphenous Local anesthetic: 5-6 mL per nerve General…

Spinal and Epidural Block

Ultrasound Guided

Authors: Wing Hong Kwok and Manoj Karmakar Introduction Ultrasound scanning (US) can offer several advantages when used to guide placement of the needle for centroneuraxial blocks (CNBs). It is noninvasive, safe, simple to use, can be performed expeditiously, provides real-time…

Thoracic Paravertebral Block

Landmark Based, Ultrasound Guided

Authors: Catherine Vandepitte, Tatjana Stopar Pintaric, and Philippe E. Gautier Thoracic paravertebral block (PVB) is a well-established technique for perioperative analgesia in patients having thoracic, chest wall, or breast surgery or for pain management with rib fractures. Ultrasound guidance can…

Lumbar Plexus Block

Ultrasound Guided

Figure 1: To accomplish the lumbar plexus block, a needle is inserted perpendicular to the skin plane, 4 cm lateral to the midline at the level of L3-L5. Essentials Indications: surgery on the hip, anterior thigh, and knee Landmarks: iliac…

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