Anesthesia Key

Key Points • In approximately 5% of adult patients, the sacral hiatus is nearly impossible to cannulate with needle or catheter. • The tissue mass overlying the sacrum in some…

Key Points • Checking the anatomy with ultrasound before and during the procedure assures success. Because the sacrum is not fully ossified, it can still be penetrated by the ultrasound…

Key Points • Epidural block can be performed in cervical, thoracic, and lumbar regions of the vertebral column. • Paramedian approach is the preferred technique for thoracic epidural, while median…

Key Points • Spinal anesthesia is unparalleled in that a small mass of local anesthetic can produce dense surgical anesthesia. • Bupivacaine is the ideal drug for spinal anesthesia. •…

Key Points • Quadratus lumborum (QL) block is a novel approach for managing postoperative pain in patients undergoing abdominal and hip surgeries. • The sensory dermatomal coverage of the QL…

Key Points • The subcostal transversus abdominal plane (TAP) approach is very useful for supraumbilical procedures. • The most cephalad sensory dermatomal spread is T8. • The bilateral continuous catheter…

Key Points • The transversus abdominis plane (TAP) block is a tissue plane block depending on adequate spread of local anesthetics through the plane—accordingly a minimum volume of 20 mL…

Key Points • A high-frequency transducer is preferred for this block. • The rectus sheath block provides periumbilical somatic analgesia from the levels T9–T11 and is used for surgeries involving…

KEY POINTS • The erector spinae plane block (ESPB) is actually used for acute and chronic thoracoabdominal pain syndromes, although its indication has been described for the treatment of pain…

Key Points • The thoracic paravertebral block, with or without catheter, can be used in lieu of thoracic epidural catheter for unilateral procedures and for breast surgeries. • Pneumothorax is…