Regional Anesthesia

Bucky Boaz, ARNP-C

Indications

Distortion from local infiltration

Large area Most efficacious Extensive

manipulation

Preparation

Instructions Equipment Choice of anesthetic Positioning the patient Preparation of area to be blocked Choosing the nerves to block

Locating the Nerve

Landmarks Nerve stimulator Paresthesia

Injecting the Anesthesia

No vessel or nerve bundle Onset and duration Amount Failure

Complications and Precautions

Nerve injury Intravascular injection Hematoma Infection Limb injury

Nerve Blocks at the Wrist

Nerve Blocks at the Wrist

Median nerve– Anatomy

– Technique

Nerve Blocks at the Wrist

Median nerve– Anatomy

– Technique

Radial nerve– Anatomy

– Technique

Nerve Blocks at the Wrist

Median nerve– Anatomy

– Technique

Radial nerve– Anatomy

– Technique

Ulnar nerve– Anatomy

– Technique

Nerve Blocks of the Digits

Nerve Blocks of the Digits

Anatomy

Nerve Blocks of the Digits

Anatomy Technique

– Dorsal approach

Nerve Blocks of the Digits

Anatomy Technique

– Dorsal approach

– Ring block

Nerve Blocks of the Digits

Anatomy Technique

– Dorsal approach

– Ring block

– Palm approach

Nerve Blocks of the Digits

Anatomy Technique

– Dorsal approach

– Ring block

– Palm approach

– Web space approach

Nerve Blocks of the Digits

Complications Precautions

Nerve Blocks of the Lower Extremity

Nerve Blocks of the Lower Extremity Ankle Metatarsals Toes

Nerve Blocks of the Ankle

Nerve Blocks of the Ankle

Anatomy

Nerve Blocks of the Ankle

Nerve Blocks of the Ankle

Anatomy Technique

– Posterior tibial

Nerve Blocks of the Ankle

Anatomy Technique

– Posterior tibial

– Sural nerve

Nerve Blocks of the Metatarsals and Toes Anatomy

Nerve Blocks of the Metatarsals and Toes Anatomy Technique

– Metatarsals

– Interdigital web spaces

– Toes

Nerve Blocks of the Metatarsals and Toes Anatomy Technique

– Metatarsals

– Interdigital web spaces

– Toes

Complications and precautions

Regional Anesthesia of the Head

Regional Anesthesia of the Head

Anatomy of the fifth cranial (trigeminal) nerve

1. Ophthalmic nerve

2. Maxillary nerve

3. Mandibular nerve

Equiptment Precautions

Types of Blocks Topical anesthesia Supraperiosteal

infiltrations Infraorbital Nerve Block Inferior Alveolar Nerve

Block Mental Nerve Block Scalp Block Opthalmic (V1) Nerve

Block

Infraorbital Nerve Block

Anatomy Intraoral approach Extraoral approach

Inferior Alveolar Nerve Block

Anatomy Approach Complications

Mental Nerve Block

Anatomy Approaches

Scalp Block

Anatomy Approaches

Ophthalmic (V1) Nerve Block

Anatomy Approach

Questions?