Indication
Selective anesthesia of the limbs and the head
Techniques: anatomy-based, nerve stimulation, ultrasound-guided
Equipment
Nerve stimulator, Stimuplex needle, local anesthetic, NaCl 0.9%
Advantages/Disadvantages/Contraindications
Advantages:
- Efficient technique of anesthesia
- No block of the sympathetic chain
- Outpatients
- High precision
- High safety (US/(MSC)/BSmart)
Disadvantages:
- High training effort and increased costs
- In general, application of catheters is more difficult
Contraindications:
- Coagulation disorders
- Neuropathies
- Skin infections in the puncture area
- Unstable fractures (Nerve stimulation)
- Patient with dyspnoea (Cervical paravertebral block)
Injection pressure control (BSmart)
Correct injection:
<15 psi: perineural connective tissue
Incorrect injection:
>20 psi: intraneural injection
Video
Local anesthetics
Peripheral nerve block
Onset of effect and duration:
Lidocain 2%: 5 min/1-2 h
Mepivacain 2%: 5-10 min/1-3 h
Bupivacain 0.5%: 15-25 min/4-12 h
Ropivacain 0.75%: 10-20 min/4-12 h
Injection volumes (kg):
0.05-0.3 (0.4) ml/kg/block
General preparation
Sufficient sedation or depth of anesthesia
For example:
- Dexmedetomidin 1-2 µg/kg plus Methadone 0.2 mg/kg i.m. Propofol 1-2 mg/kg i.v. to effect
- Intubation and isoflurane anesthesia MAC 1.0
- Anesthesia monitor
- Clipping and washing with chlorhexidine or iodine soap
- Patient positioning
- Antiseptic disinfection of puncture sites with alcohol or alcohol/iodine mixture
Videos
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Complete block of the hindlimb
-
Complete block of the hindlimb (approx. 6 h post block)
Disclaimer
As with any intervention in the body, peripheral nerve blocks also carry the risk of complications. The presented procedures and dosages are thoroughly reviewed and based on currently available scientific data and clinical experience but should only be considered as guidelines along the contents of the course. The responsibility for performing the nerve blocks shown on this site as part of any anesthesia regimen or pain management lies with the executing clinician. B. Braun Vet Care GmbH and Dr. Papadopoulos cannot be held responsible for any complications or adverse effects, that may arise from the described techniques or for any mistakes in the information provided.