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Landmark-Guided Technique for Regional Anesthesia of the Lower Limb

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Regional Nerve Blocks in Anesthesia and Pain Therapy

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Abstract

Lumbosacral plexuses, closely related to one another, are formed by the ventral branches of the lumbar, sacral, and coccygeal spinal nerves. The concept underlying lumbar plexus blocks is that the course of the neural network from the transverse processes to the inguinal ligament lies within a perivascular and perineural space. Like the epidural space, this space limits the spread of the local anesthetic and conducts it to the various nerves. Two techniques are described that belong to the standard methods for blocking the lumbar plexus: the caudal (ventral) psoas compartment block (“three in-one” inguinal femoral paravascular block) and cranial (dorsal) psoas compartment block. Block of the sciatic nerve, the largest of the four nerves supplying the leg at the lower end of the lumbosacral plexus, after it exits from the greater sciatic foramen or infrapiriform foramen has been described.

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Notes

  1. 1.

    If technical difficulties arise, the catheter and Tuohy needle must always be removed simultaneously. A catheter must never be removed through the Tuohy needle (as the catheter may shear!).

  2. 2.

    If technical difficulties arise, the catheter and Tuohy puncture needles are always removed simultaneously. A catheter must never be withdrawn through a Tuohy puncture needle that remains in place (because of catheter shearing).

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Author information

Authors and Affiliations

  1. Pain Management Centre DGS – Cologne – Huerth, Cologne-Hürth, Germany

    Danilo Jankovic

  2. Anesthesia Research Unit, Instituti Orthopedici Rizzoli, Bologna, Italy

    Battista Borghi

Authors
  1. Danilo Jankovic
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  2. Battista Borghi
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Corresponding author

Correspondence to Danilo Jankovic .

Editor information

Editors and Affiliations

  1. DGS – Cologne – Huerth, Cologne-Hürth, Germany

    Danilo Jankovic

  2. Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON, Canada

    Philip Peng

Popliteal Sciatic Nerve Block

Popliteal Sciatic Nerve Block

See Chap. 60 Popliteal Sciatic Nerve Block.

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Jankovic, D., Borghi, B. (2022). Landmark-Guided Technique for Regional Anesthesia of the Lower Limb. In: Jankovic, D., Peng, P. (eds) Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-88727-8_70

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  • DOI: https://doi.org/10.1007/978-3-030-88727-8_70

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  • Online ISBN: 978-3-030-88727-8

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