Mayo Clinic Analgesic Pathway: Peripheral

Resolving to expedite the recovery process, this reference describes a comprehensive multimodal approach to intraoperative regional anesthesia and postoperative analgesia in patients undergoing major lower extremity orthopedic surgery-spanning the entire selection of regional anesthesia equipment, strategies in pain management, and practical treatment guidelines for the management of inpatient and ambulatory peripheral nerve catheters.The authors' systematic approach to regional anesthesia and analgesia in patients undergoing total joint replacement has been recognized for its scientific and educational value by the American Academy of Orthopaedic Surgeons and the American Society of AnesthesiologistsThis guide helps readers by:· offering prudent, practical management guidelines for optimal medical care· describing needle redirection cues for each block· illustrating anatomical landmarks for selecting the needle insertion site· supplying detailed medical illustrations of proper positioning for the patient and proceduralist

Robert L. Lennon is Supplemental Consultant, Department of Anesthesiology, Mayo Clinic; Associate Professor of Anesthesiology, Mayo Clinic College of Medicine; Rochester, Minnesota Terese T. Horlocker is Consultant, Department of Anesthesiology, Mayo Clinic; Professor of Anesthesiology and of Orthopedics, Mayo Clinic College of Medicine; Rochester, Minnesota

Section I: Principles of Lower Extremity Peripheral Nerve Block

1

(32)

1. Neural Anatomy

3

(8)

2. Dermatomes and Osteotomes

11

(4)

3. Preoperative Assessment and Monitoring

15

(4)

4. Techniques and Equipment for Neural Localization

19

(6)

5. Selection of Local Anesthetic and Adjuvants

25

(6)

6. Neurologic Complications

31

(2)

Section II: Lumbar Plexus Block

33

(32)

7. Psoas Compartment Approach

35

(8)

8. Fascia Iliaca Approach

43

(4)

9. Femoral Nerve Block

47

(4)

10. Lateral Femoral Cutaneous Nerve Block

51

(4)

11. Obturator Nerve Block

55

(4)

12. Saphenous Nerve Blocks

59

(6)

Section III: Sciatic Nerve Block

65

(36)

13. Classic Posterior Approach of Labat

67

(4)

14. Parasacral Approach

71

(4)

15. Subgluteal Approach

75

(4)

16. Anterior Approach

79

(4)

17. Lateral Popliteal Approach

83

(4)

18. Posterior Popliteal Approach

87

(4)

19. Ankle Block

91

(10)

Section IV: Mayo Clinic Analgesic Pathway

101

20. Mayo Clinic Total Joint Anesthesia and Analgesic Pathway

103

(10)

21. Regional Anesthesia and Analgesia in the Patient Receiving Thromboprophylaxis

113

(4)

22. Management of Inpatient Peripheral Nerve Catheters

117

(4)

23. Management of Ambulatory Peripheral Nerve Catheters

121

(4)

24. Nursing Management of Peripheral Nerve Catheters

125

(2)

25. Future Directions

127

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Mayo Clinic Analgesic Pathway: Peripheral Nerve Blockade for Major Orthopedic Surgery

Summary

Author Biography

Table of Contents

Supplemental Materials