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Lower Extremity- Peripheral Nerve Blocks
Section 1
9
Chemistry
Graduate
12/02/2015

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Term
peripheral nerve block
Definition
injection of a LA around a nerve or group of nerves with blockade of nerve impulse conduction, causing temporary analgesia and loss of SENSORY AND MOTORO FUNCTION. (not necessarily both)
Term
Benefits of PNBs
Definition
improved analgesia
decreased need for narcotics
decreased PACU/hospital stay
decreased PONV
improved blood flow to extremity
improved function recovery
patient satisfaction
improved cognitive recovery
Term
PNBs directly decrease:
Definition
PONV
ileus
resp depression
hypotension
bradycardia
lethargy
confusion/delirium
allergic reactions
Term
contraindications
Definition
patient refusal
patient's cognitive function
infection/burn at injection site
exisiting neryologic injury
LA allergy
vascular grafts
coagulopathy
Term
choice of LA
Definition
consider: duration, onset, toxicity profile, cost, site

usually lidocaine or bupivicaine
Term
epinephrine
Definition
increases duration
local vasoconstriction, decreased vascular uptake
improved quality (d/t alpha 2 agonism)
decreased LA blood conc.

concerns: worsening neurologic injury, systemic absorption (HOTN/tachycardia)
Term
Pre-op neurologic injury
Definition
MECHANICAL damage to nerve
HEMATOMA formation
Term
intra-op
Definition
surgical injury
positioning
tourniquet injury
ISCHEMIA
COMPRESSION
Term
post-op
Definition
PRESSURE injury from positioning
COMPRESSION (cast)
ischemia (loss of blood flow)
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