Intravenous Regional Anesthesia

Author(s):  
Edward D. Frie

The intravenous injection of local anesthetic into an exsanguinated limb provides anesthesia by diffusion of the drug to peripheral nerves supplied by small vessels. Intravenous regional anesthesia is most commonly used for procedures on the hand, wrist, and digits; however, it may also be effective for minor surgery on the foot and ankle. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.

Author(s):  
Adam K. Jacob ◽  
James R. Hebl

Ankle blockade is a safe, efficacious, and well-tolerated anesthetic for foot and ankle surgery The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.


Author(s):  
Adam K. Jacob

Sciatic nerve blockade is performed to achieve anesthesia and analgesia of the distal lower extremity, including the anterior and posterolateral leg, ankle, and foot. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of ultrasound guidance is also discussed.


Author(s):  
David E. Byer

Wrist blockade anesthetizes the median, ulnar, and radial nerves at the level of the wrist. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.


Author(s):  
Michelle A. O. Kinney

The intersternocleidomastoid block is indicated for procedures of the shoulder, upper arm, and forearm. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.


Author(s):  
David E. Byer

Digital nerve blocks are used to provide anesthesia to one or more fingers or toes The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.


Author(s):  
Thomas J. Jurrens

Suprascapular blockade provides analgesia of the shoulder joint, capsule, and skin without anesthetizing the phrenic nerve. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.


Author(s):  
James R. Hebl ◽  
Adam K. Jacob

Popliteal blockade is one of the most commonly used and widely accepted peripheral nerve block techniques for the lower extremity. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of ultrasound guidance and continuous nerve catheters is also discussed.


Author(s):  
Thomas J. Jurrens ◽  
James R. Hebl

Fascia iliaca blockade is used to provide postoperative analgesia in children and adults undergoing proximal lower extremity procedures. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Ultrasound guidance and use of continuous nerve catheters is also discussed.


Author(s):  
Sandra L. Kopp

Posterior lumbar plexus, or psoas compartment, block is primarily used to provide unilateral anesthesia and analgesia to the proximal aspect of the thigh and hip. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of peripheral nerve catheters is also reviewed.


Author(s):  
Steven R. Rettke ◽  
Hugh M. Smith

Nerve blocks at the elbow have limited but specific clinical applications, which are described. In addition, the following aspects of the procedure are reviewed: relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of ultrasound guidance for this block is also reviewed.


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