TY  - CHAP
M1  - Book, Section
TI  - Peripheral Nerve Blocks
A1  - Spence, Brian C.
A1  - Herrick, Michael D.
A1  - Parra, Michelle C.
A2  - Longnecker, David E.
A2  - Mackey, Sean C.
A2  - Newman, Mark F.
A2  - Sandberg, Warren S.
A2  - Zapol, Warren M.
Y1  - 2017
N1  - 
T2  - Anesthesiology, 3e
AB  - KEY  POINTSThe  duration  of  the  surgical  procedure,  patient  comorbidities,  and  postoperative  factors,  such  as  the  early  need  for  the  use  of  the  operative  extremity  and  potential  for  significant  postoperative  discomfort,  should  all  be  used  to  determine  the  selection  of  local  anesthetic  and  technique.The  lowest  clinically  effective  dose  of  a  local  anesthetic  should  be  used  whenever  possible  to  minimize  toxicity.Studies  to  date  have  shown  that  ultrasound  decreases  the  time  for  placement  of  peripheral  nerve  blocks,  increases  the  speed  of  block  setup,  and  improves  the  “quality”  of  the  block  by  modest  amounts  when  compared  with  the  traditional  landmark  techniques  or  nerve  stimulation.Because  the  frequency  of  neurologic  injury  is  low  with  peripheral  nerve  blocks,  no  single  technique  has  been  shown  to  be  “safer”  than  another.The  use  of  ultrasound  does  not  replace  the  need  for  a  fundamental  understanding  of  anatomy  when  placing  peripheral  nerve  blocks.The  interscalene  approach  to  the  brachial  plexus,  unlike  the  supraclavicular  approach,  will  most  likely  miss  the  ulnar  distribution  of  the  hand;  thus,  it  is  not  suitable  as  a  complete  anesthetic  distal  to  the  elbow.The  adductor  canal  block  has  become  an  alternative  to  the  femoral  nerve  block  for  total  knee  arthroplasty  as  an  approach  to  minimize  motor  block  in  these  patients.The  popliteal  approach  to  the  sciatic  nerve  can  be  done  with  the  patient  supine  or  prone  and  is  ideal  for  surgeries  involving  the  lower  leg  or  foot.  If  the  medial  aspect  of  the  lower  leg  or  foot  is  required  for  surgical  anesthesia,  then  the  saphenous  portion  of  the  femoral  nerve  must  be  included.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1144120142
ER  -