This is the London Society of Regional Anaesthesia's video archive. Here can be found educational videos relating to the practice of ultrasound-guided regional anaesthesia from our courses and faculty.
This is definitely the old way to do supraclavicular block. Now it is accepted from all anesthesiologists that no need to go inside the plexus and "blow it like a grenade ". Instead first shot in the clavicular a. subclavia corner and the second shot is above the plexus, this way we "sandwich" the plexus between our placed L.A.
You stated a rib under the axillary artery and vein is most likely the 2nd rib however, you scan caudally and the next rib that showed up you labeled as the 2nd rib. Please clarify.
You make a valid point! This video was made quite some time before the description of the ESP block and therefore the importance of the Erector Spinae Complex of muscles was not appreciated and therefore not highlighted. It is incredible now to view this video with a different and more informed “lens” Hopefully you still found the video useful?
Thanks sir. Let me ask you a question please. Which muscles did you pass through from superficial to profoundus during the this intervention? And If we would think the putting a perineural catheher to this space, where should we prefer? For example middle of the sheath or further into, below the corner? (Sorry for my English)
Thanks alot for ur efforts! Regarding the QL 2 (posterior) block Do we pierce the med. Thoracolumbar fascia then inject above the QL tissue? Or we dont pierce the med. Thoracolumbar fascia?
Probably should’ve mentioned/reminded that lumbar plexus nerves run through the psoas so in particular with TQL you really have to be sure you don’t inject ANY local or you will get the leg weakness you mentioned. You can use a three-way stopcock and inject saline for needle tip placement and then switch to your local. Just a thought...
is a great video but I noticed on the superficial peroneal nerve your anatomy explained is actually backwards.. the extensor digitorum longus is medially and the peroneus brevis is laterally ... you needle on the ultrasound is coming from the medial aspect of the screen and that muscle is the EDL not the PB. otherwise is a great video ! .. thank you and sorry for the comment, I just wanted to point that out so people dont get confused.
The annotated scan is correctly labelled, the image is flipped left to right for the needling part of the video, so the needle comes in from the anterior aspect over EDL.
Thank you for generously sharing your work LSORA team, please keep up the good work.. Was there at the best Video session by your team at ESRA 2017.. it was spectacular.. looking forward to it..
Hope you are finding the video useful. Thanks for all the "likes" and comments. We are always striving to improve, so if you have any useful feedback or constructive criticism, please do let us know. Many thanks- Amit Pawa