Lower Extremity Nerve Blocks Flashcards
Regional anesthesia can be useful for patient who have had a history _______ after GA?
Nausea and vomiting
Admin benzo’s before regional anesthesia can take care what 2 things regarding the patient?
- anxiety
- seizures (that could possibly occur from LA toxicity)
When administering regional anesthesia to a patient who has pre-existing neurological deficits, what must you make sure to do?
- informed consent
- document very well what the pre-op deficit is
What are the classes of local anesthetics?
- esters (one i esters)
- amides (two i amides)
Which LA has the greater potential for producing and allergic reaction?
Esters
LA toxicity depends on 4 factors?
- site of injection
- total dose
- anesthetic used
- use of epi
In what order of structure will cause maximum to minimum absorption of LA?
- intercostals, caudal, epidural, brachial plexus, sciatic, lumbar plexus and femoral
4 ways you can locate a nerve?
- anatomic relationships
- paresthesias
- nerve stimulator technique
- ultrasound
The sciatic nerve block, blocks which nerves?
- L4- S3
Sciatic nerve block provides anesthesia to what aspect of the leg?
- the foot, lower extremity distal to the knee and posterior leg
For the sciatic nerve block a line is drawn from what anatomical structure to what anatomical structure?
- the greater trochanter to the posterior superior iliac spine
For the sciatic nerve block a 2nd line is drawn from what anatomical structure to what anatomical structure?
- the greater trochanter to the sacral hiatus
For the sciatic nerve block, after drawing the 2 lines, where is the needle inserted?
- where the latter line intersects the perpendicular line
Dorsiflexion or eversion of the foot indicates stimulation of which nerve?
- common peroneal
Plantar flexion of the foot and toes indicates stimulation of which nerve?
- tibial nerve
How much volume of LA do you inject into sciatic nerve
- 20 to 30ml
A femoral nerve block provides anesthesia to what aspect of the leg?
- anterior portion of the thigh, knee and small part of medial foot
A femoral nerve block results in the inability to…
- abduct leg or extend the lower leg
Placement of the needle for a femoral nerve block is?
- lateral to the femoral artery and inferior to the inguinal ligament
- needle inserted perpendicular to the skin, then advanced cephalad
Volume of LA injected for e femoral nerve block?
- 25 - 35ml
A popliteal nerve block is indicated for what kind of surgery?
- foot and ankle surgery
Major landmarks for the popliteal nerve block:
- popliteal fossa crease
- bicep femoris tendon
- semitendinosus and semimembranosus
In the popliteal nerve block, the needle is inserted approx how many centimeters above the popliteal crease?
- 7cm
Ankle blocks are indicated for what kind of surgeries?
- below the ankle procedures
