Sphenopalatine Ganglion Block

Sphenopalatine Ganglion Block

Block of the sphenopalatine ganglion may be used to provide regional anesthesia for nasal and dental surgery or for fiberoptic airway management. It may also be used in the management of acute migraine, acute cluster headache, and facial neuralgia. For the transnasal approach, the patient is placed supine. With a cotton tip soaked in 4 lidocaine or 10 cocaine, the first applicator is passed along the upper border of the first turbinate until contact is made Figure 20-18 Approaches for the...

Continuous Sciatic Nerve Infusion

Sciatic Nerve Block Injection Notes

Patients with CRPS I and II, vascular insufficiency, and unilateral leg edema from many causes are frequently managed with lumbar epidural catheters. There are, however, inherent risks with long-term placement of an epidural catheter. The sciatic catheter can be an alternative in such patients. It can eliminate the risk of epidural abscesses, hematoma formation, or catheter erosion of the dura. The unilateral affected limb can be specifically treated without numbing or weakening the opposite...

Supraclavicular Plumb Bob Technique

Plumb Bob Approach Supraclavicular Block

The patient's head is turned slightly to the contralateral side. The patient is asked to raise the head slightly off the table so that the lateral border of the clavicular head of the sternocleidomastoid muscle can be identified as it inserts onto the clavicle. This point is marked as the entry point. After skin preparation, an insulated needle is inserted at the entry site as if it were a weight (plumb bob) under gravitational pull (i.e., in a parasagittal direction) ( Fig. 2026 ). If...

Electrical Characteristics Of Peripheral Nerve Stimulators Currently Available In Clinical Practice

Electrical Nerve Stimulator Anesthesia

To determine which electrical characteristics of the PNS contributed to the localization of a peripheral nerve, the electrical properties of eight commercially available peripheral nerve stimulators and a Grass S-88 stimulator were measured. The PNS was then used in the laboratory to locate a peripheral nerve in an anesthetized cat. The controlled environment in the laboratory allowed each PNS to be used under nearly identical conditions. Experiment I Determination of Output Characteristics of...

Dural Lesions Induced By Quincke And Whitacretype Beveled Needles

Wuincke Needle Type

The studies published in the literature on postdural puncture headache (PDPH) have analyzed the use of needles with different tip designs and different external diameters. Most authors agree that needles with small external diameters pencil point designs1 cause fewer cases of PDPH because such needles (e.g., Sprotte, Whitacre types) produce less damage by separating rather than sectioning the dura mater fibers.1 However, when the morphology is examined in detail concerning the damage produced...