Paravertebral nerve blocks (PVBs) are regional anesthetic techniques that target the paravertebral space (PVS), where spinal nerves emerge from the intervertebral foramina. They allow for segmental, unilateral anesthesia without the sympathectomy and motor blockade seen in neuraxial techniques. To facilitate extubation in the OR and a shorter overall hospital course,…
Understanding neuraxial anatomy is an essential part to successfully perform epidural and spinal (intrathecal) anesthetics. Here’s a schematic outlining the layers we encounter when performing these procedures:
This will be my third dedicated month of regional anesthesiology in residency, and coupled with all the peripheral nerve blocks I’ve performed on call, it’s amazing how far I’ve come in three short years. I remember in my first month of residency, I knew virtually nothing about the anatomical considerations,…
What an absolutely incredible month! With weekends off, a week of vacation, Christmas Eve/Day off, and two academic days off to partake in Baylor Med’s anesthesiology residency interview days, I only worked a total of 14 days doing regional anesthesiology this month. In that time, I did 141 procedures. In…
I’m a little over halfway done with my regional anesthesia rotation and have accrued more neuraxial and peripheral nerve blocks than I could have ever imagined. There’s something incredibly gratifying about doing blocks one day, and seeing the pain relief it provides that evening… the next day… and the day…
Epidurals are routinely used to provide analgesia during the labor process. Many women swear by them and will request for an epidural even before they are committed to labor by the obstetrician. Others try to tough it out without any pain medications. In the interim, their discomfort with contractions and labor…
Prior to my current rotation on the acute pain service, I had three months of obstetric anesthesia – the world of lumbar epidurals for labor analgesia and surgical anesthesia. I experimented with several epidural techniques but initially settled on intermittent pressure with a saline filled glass loss-of-resistance (LOR) syringe. This allowed me…
I’ve officially finished my month as the junior resident on the regional anesthesia service. I’ll be revisiting this rotation either as a CA-2 or 3, so this was a great opportunity to lay the foundation for whatever follows.
Upper extremity nerve blocks involve blocking the brachial plexus at different points – the major blocks are interscalene, supraclavicular, infraclavicular, and axillary. So how do we decide which blocks are appropriate for a given surgery? What are the pros/cons of certain blocks over others? First of all, let’s start with a…