Peripheral & Other Blocks

Peripheral & Other Blocks John P. McDonough, CRNA, Ed.D., ARNP Professor & Director Anesthesiology Nursing

Interscalene Blcok • Know the anatomy! • Nerve stimulator improves results • Good biceps twitch down to 0.5 mV • Good for shoulder and upper arm procedures • Volume is crucial • Use immobile needle technique

Stellate Ganglion Block • Sympathetic block only • CRPS (aka- RSD) • Digit replantation surgery • Herpes zoster • Frostbite • Volume is crucial • Use immobile needle technique

Intercostal Nerve Block • Know the anatomy • Small needles • 25 G usually adequate • Analgesia • Trauma • Post surgery pain

Sciatic Nerve Block • Lower extremity surgery below the knee • Combined with “3 in 1” or other blocks of the femoral obdurator and saphenous nerves

Ankle Block • 3 major nerves are required • Tibial • Deep peroneal • Superficial peroneal • Usable for foot surgery

Blocks for hand surgery • Nerve supply to the hand • Radial • Median • Ulnar • No motor block to digits

Caudal Block • Sacral epidural • Used for: • rectal surgery • pain blocks • Volume is essential

Peripheral & Other Blocks