Anaesthetic

Question 1

How is a Posterior Tibial nerve block performed?

Answer 1

Indication
- Sole of foot procedures

Technique
- Consent + analgesia
- Prep and drape
- Identify medial malleolus
- Infiltrate 5-10mls lignocaine immediately posterior to the posterior tibial artery
- If no ultrasound and artery not palpable, inject halfway between achilles tendon and medial malleolus

Question 2

What are the benefits of regional vs local anaesthesia?

Answer 2

• Overall less painful for patient as 1 vs many injections
• Usually better analgesia
• Theoretically lower risk of LAST as smaller volume used
• Reduced risk of needle stick injury to provider
• Can be easier to infiltrate in certain areas (ie sole of foot thick and difficult to infiltrate)
• Doesn’t distort the anatomy (ie vermillion border with lip lacerations)

Question 3

How is Jet Ventilation set up and performed?

Answer 3

Question 4

How is a dorsal penile block performed?

Answer 4

• Prep and drape
• 5mls of LA without adrenaline
• Inject 1-2mls at 10 and 2 O’Clock
• Can extend to make a ring block by redirecting needle caudally and advancing along the superficialy fascia
• This numbs the ventral aspect of the penis as well