NEW YORK SCHOOL OF REGIONAL ANESTHESIA Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia, Second Edition by Hadzic Admir

Author:Hadzic, Admir
Language: eng
Format: epub
Publisher: McGraw-Hill
Published: 2011-12-07T05:00:00+00:00

Technique

The continuous popliteal block technique is similar to the single-injection technique. With the patient in the prone position, infiltrate the skin with local anesthetic using a 25-gauge needle at an injection site 7 cm above the popliteal fossa crease and between the tendons of biceps femoris and semitendinosus muscles. An 8- to 10-cm needle connected to the nerve stimulator (1.5 mA current) is inserted at the midpoint between the tendons of the biceps femoris and semitendinosus muscles. Advance the block needle slowly in a slightly cranial direction while observing the patient for rhythmic plantar or dorsiflexion of the foot or toes. After appropriate twitches are noted, continue manipulating the needle until the desired response is seen or felt using a current ≤0.5 mA. The catheter should be advanced no more than 5 cm beyond the needle tip (Figure 20.1-9). The needle is then withdrawn back to skin level while advancing the catheter simultaneously to prevent inadvertent removal of the catheter.

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