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15 Cards in this Set
- Front
- Back
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Indications for a Popliteal Block?
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Surgical procedures below the knee
Foot/ankle surgery Achilles tendon surgery Sural nerve biopsy Short saphenous vein stripping |
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What are the two approaches for the Popliteal Block?
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Intertendinous approach
Lateral approach |
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What are the landmarks for the Popliteal Block?
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(1)popliteal crease,
(2)tendons of biceps femoris (lateral) (3)semitendinosus (medial). |
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Complications of Popliteal Block?
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Nerve damage from direct injection of LA into nerve.
S/S include severe pain on attempted injection or marked resistance to injection. |
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Why would a current intensity of less than 0.2mA be a concern?
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Intraneuronal placement of needle
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Stimulation of the tibial nerve elicits what response?
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Plantar flexion and inversion
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Stimulation of the common peroneal nerve elicts what response?
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Dorsiflexion and eversion
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What nerve might require a separate block if the antero-medial leg and foot are not sufficiently blocked?
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Saphenous nerve block
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S /sx of intravascular injection of LA?
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confusion, metallic taste, tinnitus or seizures.
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What is the benefit of adding Sodium Bicarbonate to your injection?
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Increases the pH, creating a more lipid soluble solution. Less ionization results in increased speed across the cell membrane, producing a faster onset of action.
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What is the benefit to adding epinephrine (vasoconstrictor) to the block?
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Vasoconstriction at the site, decreases absorption, thereby increasing neuronal uptake and prolonging the duration of action and limiting toxic side effects.
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How do you assess effectiveness of block?
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Ask pt. to move toes and ankle: motor.
Lightly pinch foot and leg to assess analgesia: sensory to pain. If pt. responds, may have missed saphenous nerve. |
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Motor response of foot produced by stimulation of the common peroneal nerve?
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Dorsi Flexion
Inversion medially of foot |
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Motor response of foot produced by stimulation of the common Tibiall nerve?
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Plantar flexion
Flexion of the Toes Eversion (lateral) of the toes\s |
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Landmarks of the Popliteal Fossa Block?
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Semitendinosus
Biceps Femoris Popliteal Crease |
