Figure 5.1. The three-ring (“control”) syringe. This adaptation to the plunger of a standard 10-mL syringe allows greater control of injection, easier aspiration, and the opportunity to refill the syringe…

Figure 9.1. Landmarks for intercostal block. The inferior borders of the ribs are identified at their most prominent point on the back. The marks usually lie along a line that…

Figure 3.1. Lack of correlation between patient weight and peak plasma concentration after epidural administration of 400 mg of lignocaine. This same lack of a relationship between patient weight and…

Figure 10.1. Relationship between the spinous processes, transverse processes, and spinal nerves in the lumbar and thoracic spine. The lumbar spinal nerves course caudad to the transverse process of the…

Figure 13.1. Technique for intravenous regional anesthesia. A small intravenous catheter is placed in the hand and the tourniquet is applied to the upper arm. A single tourniquet may be…

Figure 1.1. Typical structures of local ester and amine anesthetic molecules.   where pH is the solution or tissue pH and pKa is the pH at which half the local…

Figure 8.1. Sacral anatomy, lateral view. A needle directed through the sacral–coccygeal membrane at a 45-degree angle will usually “pop” through the ligament and contact the anterior bone of the…

Figure 2.1. Disposition of sites for local anesthetics following peripheral nerve blocks. Nonspecific binding to extraneuronal tissues (e.g., tissue proteins, fat) and uptake into the blood stream limit the amount…