John P. McDonough, CRNA, Ed.D., ARNP

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Peripheral Other Blocks

• John P. McDonough, CRNA, Ed.D., ARNP
• Professor Director
• Anesthesiology Nursing

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Interscalene Blcok

• Know the anatomy!
• Nerve stimulator improves results
• Good biceps twitch down to 0.5 mV
• Good for shoulder and upper arm procedures
• Volume is crucial
• Use immobile needle technique

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Stellate Ganglion Block

• Sympathetic block only
• CRPS (aka- RSD)
• Digit replantation surgery
• Herpes zoster
• Frostbite
• Volume is crucial
• Use immobile needle technique

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Intercostal Nerve Block

• Know the anatomy
• Small needles
• 25 G usually adequate
• Analgesia
• Trauma
• Post surgery pain

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Sciatic Nerve Block

• Lower extremity surgery below the knee
• Combined with 3 in 1 or other blocks of the
  femoral obdurator and saphenous nerves

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Ankle Block

• 3 major nerves are required
• Tibial
• Deep peroneal
• Superficial peroneal
• Usable for foot surgery

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Blocks for hand surgery

• Nerve supply to the hand
• Radial
• Median
• Ulnar
• No motor block to digits

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Caudal Block

• Sacral epidural
• Used for
• rectal surgery
• pain blocks
• Volume is essential

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