LE blockade (Part 4): 35-43

Question 1

Tibial is lateral T/F

Answer 1

FALSE
Tibial is MEDIAL

Question 2

For a tibial the needle groove should be behind what?

Answer 2

behind the medial malleolus

Question 3

How should you perform a tibial block?

Answer 3

Needle groove behind the medial malleolus
Hit bone and then withdraw ~ 1 cm and fan injection of ~3 ml

Question 4

peroneal, sural and saphenous are (deep/superficial) nerves

Answer 4

superficial
All three nerves are superficial to deep fascia

Question 5

When blocking the peroneal, sural and saphenous superficial nerves how should you inject the LA? How much LA should you inject?

Answer 5

Inject LA into territory in which they descend.
Fan (or “ring block”) about 4 - 5 ml of LA at each site.

Question 6

Where is the saphenous nerve located?

Answer 6

Saphenous = medial, to the (medial) malleolus near the saphenous vein

Question 7

When doing a superficial peroneal block where should you inject the LA? How should it be injected (what route)?

Answer 7

SQ infiltration of LA over lateral aspect of foot, between the medial and lateral malleoli

Question 8

Sural is medial side of the foot T/F

Answer 8

FALSE
SuRAL is lateRAL side of foot

Question 9

The digital block is done by inserting what size and gauge of needle? Where do you insert that needle?

Answer 9

The digital block is done by inserting a 1” 25g needle just lateral AND medial to the base of the metatarsal

Question 10

After aspiration during a digital block how many mLs of LA is injected on either side of the digit?

Answer 10

5-8 mL of LA is injected on either side of the digit

Question 11

What technique should you use when you are injecting LA for a digital block?

Answer 11

Inject just below the skin and continue to gently inject as you gradually go deeper until you pass the metatarsal

Question 12

Similar to the digital block and used when multiple digits need to be anesthetized

Answer 12

Web block

Question 13

When doing a Web block, as you inject and proceed deeper you should go towards what?

Answer 13

the heel of the foot

Question 14

Ideally, the Web block technique will anesthetize what nerves?

Answer 14

BOTH digital nerves within the web space.

Question 15

How is a Web blcok done?

Answer 15

With a 1” 25g needle, pick a point at the midpoint of the web and inject 8-10mL of LA into the web
As you inject, proceed deeper towards the heel of the foot