Delayed onset quadriparesis and bilateral ptosis following an interscalene block- Case discussion week of 0ct 5th 2009

Interesting case report published recently in Anesthesia and Analgesia.
A nerve stimulator guided interscalene nerve block was placed for rotator cuff repair. Patient underwent an uneventful general anesthetic in the sitting position for the surgical procedure. MAP was between 60-79 during the case.
Two hours after surgery the patient was found to have weakness in [...]

Thoracic Paravertebral Block | Ultrasound for Regional Anesthesia

This is a very nice overview of an ultrasound-guided approach to the thoracic paravertebral block. This approach focuses on a single injection of local anesthetic, although it could easily be customized for catheter placement. These authors use a transverse, in-plane approach. Note their use of the Tuohy needle, an appropriate selection for a para-spinal block.
These [...]

Ultrasound-Guided Obturator Nerve Block

Continuing with our Obturator Nerve Block theme, two more excellent sites describing the anatomy and approach.
ESRA – Learning zone – Techniques – Lower Limb – Ultrasound obturator block.
USRA Obturator Nerve Block Description

YouTube – Ultrasound-Guided Obturator Nerve Block

A nice video of an ultrasound-guided obturator nerve block. Importantly, they show the anterior and posterior divisions and demonstrate separate blockage of these nerves. As a reminder, always ensure a negative aspiration AND visualize spread of local anesthetic on ultrasound. The obturator artery and vein aren’t that far away….

Thoracic Paravertebral Catheters in Cadavers

Interesting analysis, if a little disheartening. 11/20 catheters with correct paravertebral spread isn’t reassuring. Still, this may explain the variability inherent to this block’s success.

ins.diff {text-decoration:none; color:green}
del.diff {color:red}

@import “file://localhost/Users/ptighe/Library/Application%20Support/NetNewsWire/StyleSheets/Default.nnwstyle/stylesheet.css”;

Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study

British Journal of Anaesthesia – current issue 3/13/09 2:00 AM Luyet, C., Eichenberger, U., Greif, [...]