Methods of peripheral nerve block anaesthesia
Peripheral conduction blocks
Our department sets a high value on peripheral conduction blocks. These blocking techniques allow us to separately anaesthetise certain regions in the arms and legs. They are therefore mainly deployed for locomotor joint and bone surgery. Leg surgery normally requires us to combine two types of blocks. Conduction blocks of this kind allow us to even implant knee or shoulder joints without any problems. Especially older patients with a history of previous circulatory problems will benefit from these techniques because they do not strain the circulation.
The minimisation of risks is not the only factor, though. Regional conduction blocks can be continuously kept far beyond the time of surgery which makes them the ideal instrument of acute pain treatment. Optimised surgery results yield immediate benefits to the patients mainly consisting of the continuous regional analgesic treatment allowing early and nearly painless mobility and exercise therapy.
Since these methods of regional anaesthesia do without making patients unconscious, patients may made to slumber during surgery if they wish (sedation).
Peripheral conduction blocks, upper extremity
- Interscalenary plexus block
- Vertical infraclavicular plexus block (VIB)
- Axillary plexus block (plex. ax.)
Interscalenary plexus block:
e.g. fracture of the upper arm, shoulder surgery (including implantation of artificial shoulder joint = shoulder TEP, AC rupture, fracture of the collarbone (outer third only)
Sciatic nerve block:
Indication:
e.g.: Relocation surgery of lower leg, fracture of lower leg, ankle joint surgery.
To completely anaesthetise the entire leg, this block is to be combined with a femoral nerve block or a psoas block
Vertical infraclavicular plexus block (VIB):
Indication:
e.g.: fracture of the upper arm (near the elbow), elbow, forearm, wrist or hand surgery
Axillary plexus block (plex. ax.):
Indication:
e.g. elbow, forearm, wrist or hand surgery
Peripheral conduction blocks, lower extremity
Psoas block (PC):
Indication:
e.g.: Fracture of the thigh (near the knee), open knee joint surgery (replacement of cruciate ligament, implantation of artificial knee joint = knee TEP).
To completely anaesthetise the entire leg, this block has to be combined with a sciatic nerve block
Femoral nerve block:
Indication:
e.g.: Endoscopy of knee joint (arthroscopy of knee joint), taking of muscle and bone tissue samples.
To completely anaesthetise the entire leg, this block has to be combined with a sciatic nerve block
Distal sciatic nerve block:
Indication:
e.g.: Forefoot or toe surgery (hammer toe, hallux surgery, toe amputation), Achilles tendon suture