By Andre P. Boezaart MD PhD
Grasp the entire blocks required for orthopaedic anesthesia, together with either single-injection and non-stop nerve blocks! this article and its better half DVD completely overview the anatomy issues you must be aware of to successfully execute those innovations, and exhibit all sixteen crucial nerve blocks as played via experts in orthopaedic anesthesiology. plentiful full-color pictures of the series of every block - mixed with full-color drawings and images of cadaver sections of the utilized anatomy - support to make sure right needle placement for every procedure.
- Presents anatomy and methods from a number of views via anatomical drawings, gross anatomy pictures, and images of floor anatomy - making sure right needle placement for every nerve block.
- Uses a realistic, "how-to” procedure that makes the most recent innovations effortless to learn.
- Covers difficulties and pitfalls that will help you steer clear of power complications.
- Shows you the way to accomplish either single-injection and non-stop nerve blocks, and demonstrates the anatomical responses received from percutaneous stimulation of the nerves, through movies at the better half DVD.
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Extra info for Atlas of Peripheral Nerve Blocks and Anatomy for Orthopaedic Anesthesia
Boezaart AP, Raw RM: Sleeping beauty or big bad wolf [editorial]. Reg Anesth Pain Med 2006;31:186-191. 8. Boezaart AP, Franco FC: Thin sharp needles around the dura. Reg Anesth Pain Med 2006;31:388-389. 53 9. Voermans NC, Crul BJ, De Bondt BJ, et al: Permanent loss of cerebral spinal cord function associated with the posterior approach. Anesth Analg 2006;102:330. 10. Boezaart AP: Please don’t blame the block … [letter]. Anesth Analg 2007;104:211-212. Chapter Supraclavicular Block ■ Single-Injection Supraclavicular Block 4 CHAPTER 4: Supraclavicular Block SINGLE-INJECTION SUPRACLAVICULAR BLOCK Introduction The supraclavicular approach to the brachial plexus is a technique usually associated with rapid-onset, predictable, and dense anesthesia (1,2).
On the bed in the supine position) or poorly ﬁtted arm slings are the ulnar nerve at the elbow or the radial nerve as it curls around the elbow. The use of an arm sling is important to prevent traction injury to the brachial plexus. Speciﬁc Anatomic Considerations The osteotomes (see Fig. 2-1), dermatomes (see Fig. 2-2), and neurotomes (see Fig. 2-3) shown for the single-injection interscalene block are similar to those for the continuous interscalene block. It should, however, be noted that although a wider spread of local anesthetic will be present during high-volume initial bolus injections, the area of block coverage will be smaller and more nervespeciﬁc during the infusion of a smaller volume of a more dilute regional anesthetic agent.
The anterior scalene muscle, by inserting in the medial border of the ﬁrst rib, comes in contact medially with the pleural dome and becomes an important landmark to locate it. 57 There is no pleural dome lateral to the anterior scalene muscle. Because the anterior scalene is located in almost the same parasagittal plane as the sternocleidomastoid muscle, the parasagittal plane of the lateral insertion of this muscle on the clavicle can be used as a landmark to locate the lateral boundary of the pleural dome in the neck.