Truncal Blocks Flashcards
What does a PECS 1 block targets the facial plane b/t what?
Pectoralis major and minor muscles
What does a PECS 2 block entail?
Includes a PECS1(pectoralis major and minor) block with an additional injection of local anesthetic b/t the pectoralis minor and serratus anterior muscles
What does the thoracic intercostal n innervate?
T1-T6
Innervates the chest and breast
Intercostal muscles
What does the lateral pectoral n innervate?
C5-C7
Innervates the pectoralis major
What does the medial pectoral n innervate?
C8-T1
Innervates the pectoralis major AND pectoralis minor
What does the long thoracic n innervate?
C5-C7
Chest wall superficial to serratus anterior
What does the thoracodorsal n innervate?
C6-C8
Latissimus dorsi
What are the Indications for a intercostal nerve block?
Rib fractures, herpes zoster, surgical procedures of chest and abd and chest tube placement
What are some downsides to a intercostal block?
Must block multiple levels
High risk of LAST
What is a paravertebral block referred to as?
Unilateral epidural
What is the purpose of a paravertebral block?
To provide segmental anesthesia that targets the spinal nerves (both somatic and sympathetic)
What are some indications for a paravertebral block?
Procedures:
Thoracic, breast, chole, hernia, and appendectomy
Pain management: rib fx, flair chest, blunt trauma, osteoporotic fx, herpes zoster
What are the risks of paravertebral blocks?
Risk of LAST
Pneumo
Intrathecal injection
What are the 3 regional blocks that are best for rib fractures?
Intercostal
Paravertebral
Erector spinae
What 3 muscles does the body rector spinae consist of?
I LONG for SPIN class
I: iliocostalis
LONG: longissumus
SPIN: Spinalis
What are the indications for an erector spinae class?
Neuropathic pain, rib fx, lumbar spine, thoracic surgery, cardiac surgery, breast surgery, bariatric
What are the 4 muscle groups involved in a TAP block?
rectus abdominis
Internal oblique
External oblique
Transverse abdominis
What is a key anatomical reference point for a TAP block?
Triangle of Petit
Where do you inject anesthetic for a TAP block?
Between the internal oblique and transverse abdominis
what are some indications for a TAP block?
Hernia
Appendectomy
Lap abdominal procedures
C section
Gyn procedures
What is the Subcostal approach in TAP blocks?
Procedures ABOVE the umbilicus
What is the lateral AND posterior approach?
Procedure BELOW the umbilicus
What type of procedures is a rectus sheath block indicated for?
Any procedure with a midline abdominal incision
Hernias, c sections, tubal ligations
In a quadratus Lumborum (QL)1 block, where is the LA injected?
Lateral to QLM
In a quadratus Lumborum (QL)2 block, where is the LA injected?
LA is injected posterior to the QLM
In a quadratus Lumborum (QL) 3 block, where is the LA injected?
LA is injected anterior
