WWW.NURSE-ANESTHESIA.ORG - Regional Anesthesia http://www.nurse-anesthesia.org/ This is our online resource for Regional Anesthesia. It includes Basic, Intermediate and Advanced Techniques with pictures and videos compliments of nysora. Only SRNA/CRNA groups can see this fourm en Thu, 23 May 2013 19:48:18 GMT vBulletin 60 http://www.nurse-anesthesia.org/images/styles/BlueDemon/misc/rss.png WWW.NURSE-ANESTHESIA.ORG - Regional Anesthesia http://www.nurse-anesthesia.org/ Recommendations for Echogenic, Insulated block needle http://www.nurse-anesthesia.org/showthread.php/16698-Recommendations-for-Echogenic-Insulated-block-needle?goto=newpost Tue, 14 May 2013 21:23:30 GMT Want to upgrade our needle selections, and was wondering which echogenic insulated block needle people were using, and what you are happiest with. ... Want to upgrade our needle selections, and was wondering which echogenic insulated block needle people were using, and what you are happiest with.

Thanks,
Paul ]]> Regional Anesthesia pdsr http://www.nurse-anesthesia.org/showthread.php/16698-Recommendations-for-Echogenic-Insulated-block-needle Saphenous Nerve Block http://www.nurse-anesthesia.org/showthread.php/16671-Saphenous-Nerve-Block?goto=newpost Wed, 08 May 2013 22:59:50 GMT I have been messing around with the saphenous nerve blocks and different views. Pic Number 1: Mid thigh view within adductor canal (before the... I have been messing around with the saphenous nerve blocks and different views.

Pic Number 1: Mid thigh view within adductor canal (before the femoral artery gives rise to the descending genicular artery)

Pic Number 2: Just inferior to the adductor canal where the descending genicular artery takes off. You can see the femoral vessels diving deeper through the adductor hiatus. You can also see what looks like the saphenous nerve following the DGA.

Pic Number 3: Distal thigh a couple centimeters above superior patella border. This is a long axis view of the sartorius muscle. You can see the deep sartorius border. My idea is that you can use an in-plane catheter insertion sub-sartorius where the saphenous nerve is located. The benefit of this technique is that the catheter is advancing superiorly up the back side of the sartorius muscle.

What do you all think?

Saphenous Nerve Block.pdf
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]]> Regional Anesthesia TheBones http://www.nurse-anesthesia.org/showthread.php/16671-Saphenous-Nerve-Block Fun regional case http://www.nurse-anesthesia.org/showthread.php/16660-Fun-regional-case?goto=newpost Mon, 06 May 2013 02:52:43 GMT I did a case this evening on a gentleman that fell off a ladder and fractured his distal tibia. About an 8 cm incision with bone sticking out. Ortho... I did a case this evening on a gentleman that fell off a ladder and fractured his distal tibia. About an 8 cm incision with bone sticking out. Ortho decides to do an I&D and splint, plan to rod on Tuesday. Pt was drinking at time of incident and so I considered him a full stomach (BAC was <10 mg/dL on lab draw), Hypertensive in 180s, on a slew of cardiac meds. Denies any cardiac interventions, but takes nitro tabs on a regular basis for CP. Borderline diabetic. 50 pack yr smoker. Has had 5 back surgeries, including rodding.

I chat with the guy about doing blocks and possibly a spinal. Originally wanted to do an epidural considering he was not having the rodding until Tuesday, but with his hx of back surgery, I didn't even want to head down that route. I was looking for the best way to get him through the case without doing a GA and still provide good post op pain relief.

Ultimately decided on this:Femoral nerve catheter.jpgPopliteal nerve catheter.jpgTibia fx.jpg

Femoral catheter and popliteal catheter. Did each of the blocks with mix of 15 ml 0.5% Bupivacaine and 15 ml 2% Mepivacaine. Got the pt through the case with minimal sedation and now the pt should have good pain relief until the rodding on Tuesday. Will run Ambit pumps with 0.25% Bupivacaine at 6 ml/hr with PCA 3 ml q 30 min.
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]]> Regional Anesthesia Shane http://www.nurse-anesthesia.org/showthread.php/16660-Fun-regional-case What do you guys use for your single shot PNBs? http://www.nurse-anesthesia.org/showthread.php/16623-What-do-you-guys-use-for-your-single-shot-PNBs?goto=newpost Fri, 26 Apr 2013 19:26:06 GMT So what local anesthetic does everyone use for their single shot long acting PNBs? Bupivicaine or Ropivicaine? Epinephrine or Not? Decadron is a... So what local anesthetic does everyone use for their single shot long acting PNBs? Bupivicaine or Ropivicaine? Epinephrine or Not? Decadron is a given so I wont even ask about that. Why do you use the mix that you use? I am just interested to hear everyone's rational for what they use. ]]> Regional Anesthesia BrianCRNA http://www.nurse-anesthesia.org/showthread.php/16623-What-do-you-guys-use-for-your-single-shot-PNBs