Friday, May 20, 2011

REGIONAL ANESTHESIA LOWER LIMB













LOWER LIMB

Lumber plexus block (LPB) is performed from a posterior approach with a translumber, paravertebral needle placed to stimulate the plexus. A volume of 25 to 30 ml of LA provides adequate block.

An anterior approach to LPB is described at the groin with placement of the needle into the femoral nerve sheath and injection of 25 to 30 ml of LA.

The surgical requirements and ability to position a patient in the lateral position determine which approach is chosen. One or both halves of the nerve are identified, and 20 to 40 ml of LA injected to achieve blockade. The classic approach deep to the gluteal muscles is easily made at the same time.

Ankle block is a reliable technique that can used as sole anesthetic or for postoperative analgesia for procedures on the foot. The nerves to the foot diverge below the knee, and five separate nerve branches must be blocked for complete anesthesia as shown in. the entire ankle block requires 20 to 25 ml of LA.

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