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Review
. 2005 May;5(2):5-19.
doi: 10.17305/bjbms.2005.3278.

Peripheral nerve blocks for perioperative management of patients having orthopedic surgery or trauma of the lower extremity

Takashige Iwata  1 , Sundaram Lakshman, Alpana Singh, Marina Yufa, Rich Claudio, Admir Hadzić
Affiliations
Review

Peripheral nerve blocks for perioperative management of patients having orthopedic surgery or trauma of the lower extremity

Takashige Iwata et al. Bosn J Basic Med Sci. 2005 May.

Abstract

Over the past decade several developments have lead to an increased interest in lower extremity PNBs including transient neurologic symptoms associated with spinal anesthesia, increased risk of epidural hematoma with the introduction of new antithromboembolic prophylaxis regimens, and evidence of improved rehabilitation outcome with continuous lower extremity PNBs. Simultaneously, the field of lower extremity blockade has been revolutionized through our better understanding of functional regional anesthesia anatomy, introduction of new drugs, better and more sophisticated equipment and wider teaching of lower extremity nerve block techniques. This review focuses on techniques and applications of lower extremity nerve blocks in patients having orthopedic surgery or trauma of the lower extremity, as well as potential complications and means to avoid them.

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Figures

FIGURE 1
FIGURE 1
Lumbar Plexus Block: A10 cm long needle is inserted at L3/4 level and 3-4 cm lateral to the midline. (Reproduced with Permission from: HadZicA., Vhka J. Peripheral Nerve Blocks: Principles and Practice. McGrawHiH New York, NY, 2003.).
FIGURE 2
FIGURE 2
Femoral Nerve Block: A 5 cm needle is inserted at the femoral crease and immediately laterally to the pulse of the femoral artery The nerve is typically stimulated at a depth of 1-3 cm. (Reproduced with Permission from: HadiuiA., Vhka J. Peripheral Nerve Blocks: Principles and Practice. McGrawHUL New York, NY.2003.).
FIGURE 3
FIGURE 3
Sciatic Nerve Block: Anatomical relationships of importance to the technique. (Reproduced with Permission from: Hadžić A., Vloka J. Peripheral Nerve Blocks: Principles and Practice. McGrawHill, New York, NY, 2003.).
FIGURE 4
FIGURE 4
Popliteal Sciatic Block Through the Lateral Approach: Surface landmarks. (Reproduced with Permission from: HadZidA., Vhka J. Peripheral Nerve Blocks: Principles and Practice. McGrawHill, New York, NY, 2003.).
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References

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