Suprascapular block
Key Points • High-frequency, 38-mm broadband linear array transducer is preferred for this block. • For catheter insertion, the Tuohy needle is usually used. The catheter is placed beneath the…
Interscalene block
Perspective Interscalene block (classic anterior approach) is especially effective for surgery of the shoulder or upper arm because the roots of the brachial plexus are most easily blocked with this…
Equipment and ultrasound
Equipment Needles, catheters, and syringes Effective regional anesthesia requires comprehensive knowledge of equipment—that is, the needles, syringes, and catheters that allow the anesthetic to be injected into the desired area….
Upper extremity block anatomy
Key Points • Along its course above the clavicle, the brachial plexus is bounded by the anterior and middle scalene muscles. The two muscles constitute the scalene triangle with its…
Pharmacology
Regional anesthesia is a fast-growing field with application in a wide range of surgical procedures. Better technique with the help of ultrasound, better and safer local anesthetics, and better drug…
Pharmacology of local anesthetics in pediatrics
Key Points Neonates and infants are more prone to developing systemic toxicity to local anesthetics (LAs), particularly amide LAs, compared with older children and adults. This is due to reduced…
Delivering Value Based Care: The UK Perspective
Introduction: Rising Demand and Resource Constraint One of the few constants throughout health-care is an inexorable rise in demand. This rise has been ongoing for many years and is driven…
Transitions From Hospital to Home
Worldwide more than 200 million surgeries are performed each year; in the United States more than 50 million inpatient procedures occur annually. In 2009, the World Health Organization demonstrated that…
Improving Health-Care Quality Through Measurement
“Wherever we see systematic measurement of results in health-care–no matter what the country–we see those results improve.” Michael E. Porter, Harvard Business Review (October 2013) Extensive evidence exists demonstrating that…
Postoperative Cognitive Dysfunction and Delirium
Introduction Since the inception of anesthesia changed and expanded surgery, some patients have experienced changes in cognitive function postoperatively. Elderly patients are at higher risk of these changes in neurocognitive…
