Other rando blocks from outline (not on ppt)

Question 1

What is the PENG block?

Answer 1

Pericapsular Nerve Group (PENG) Block.
-A single-injection block for analgesia following hip fracture and arthroplasty.
-Analgesic block = lower volumes needed

Question 2

What nerves are blocked with the PENG Block?

Answer 2

-Femoral Nerve (articular branches)
-Accessory Obturator n.
-Obturator n.

Spares part of Femoral Nerve that innervates Quads (no loss of motor function)

Question 3

How do you perform a PENG Block?

Answer 3

-Low frequency (2-5 MHz) curvilinear array transducer used in transverse orientation
-Probe placed parallel to the inguinal ligament at the level of the ASIS.
-Slide caudal until Anterior Inferior Iliac Spine and Pubic Ramus are visible
-Identify FN, artery, and vein
-Insert needle lateral to medial between the Psoas muscle

Question 4

What are the risks associated with the PENG Block?

Answer 4

Risk of hitting ureters due to proximity to the Obturator Nerve

Question 5

What is the Erector Spinae (ESP) Block?

Answer 5

Interfascial plane technique block that targets LA injection superficial to the transverse process and deep to the erector spinae muscles of the back.
-Significant craniocaudal spread occurs with this block (single injection)

Question 6

What are you trying to block with the Erector Spinae Block?

Answer 6

The dorsal and ventral rami of the thoracic spinal nerves at the level of injection.
-Provides unilateral analgesia (bilateral injection needed for midline procedures)

Question 7

What are the uses for the Erector Spinae Block?

Answer 7

-Lumbar spine surgery
-Video-assisted thoracic surgery
-Breast surgery
-Rib fractures
-Bariatric surgery
-Abdominal procedures

Question 8

What is the Lumbar Plexus (Psoas Compartment) Block?

Answer 8

-The L2-L4 nerve roots form the Lumbar Plexus within the Psoas Muscle
-3 in 1 block: blocks the plexus as it lies in the fascial plane bordered medially by the vertebral column, dorsally by the QLM, and ventrally by the Psoas Major muscle.
-Blockade of the plexus as a unit can occur by injecting LA into the fascial sheath surrounding the plexus.
-Advanced technique, high risk for complications.

Question 9

What are the complications associated with the Lumbar Plexus (Psoas Compartment) Block?

Answer 9

-Epidural spread of LA (most common)
-Spinal Anesthesia
-LAST
-Hypotension
-Renal hematoma