Landmarks for Peripheral Nerve Blocks Upper and Lower Extremities

Upper limb nerve blocks

Brachial plexus blockade has enjoyed great popularity since it was first reported in 1884. As the ventral primary rami of cervical nerves 5–8 and a part of the first thoracic nerve emerge from the intervertebral foramina, they are invested in a fascial sheath that runs to a point distal to the axilla. Effective regional anaesthesia can be achieved with single or multiple injections at a variety...

Upper Extremity Nerve Blocks

Comparison of blood pressure measurements on the upper and lower extremities during spinal anesthesia

Introduction: During spinal anesthesia, measurement of blood pressure is often obtained by an indirect method using an inflatable cuff on the upper arm. The relationship between the blood pressure measurements at the two sites in patients undergoing spinal anesthesia is unclear. This study was designed to evaluate the difference observed in systolic blood pressure (SBP) taken from the upp...

Peripheral arterial disease of the lower extremities

Persons with peripheral arterial disease (PAD) are at increased risk for all-cause mortality, cardiovascular mortality, and mortality from coronary artery disease. Smoking should be stopped and hypertension, dyslipidemia, diabetes mellitus, and hypothyroidism treated. Statins reduce the incidence of intermittent claudication and improve exercise duration until the onset of intermittent claudica...

Dexmedetomidine as adjuvant for peripheral nerve blocks.

Marhofer and colleagues Malenfant Rancourt and colleagues Site Ulnar nerve (volunteers) Posterior tibial nerve (volunteers) Medication 3 ml ropivacaine 0.75% 10 ml ropivacaine 0.5% Dose of adjuvant 20 mg dexmedetomidine 1 mg kg dexmedetomidine ( 50–70 mg) Results Sensory block 350(SD 54) min ropivacaine only(5.8 h) vs 555 (118) min ropivacaine+ dexmedetomidine (9.25 h) 972 (SD 120) min ropivaca...