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Future Trends in Regional Anesthesia Techniques

  • Amanda Kumar
  • Jeff Gadsden
Chapter

Abstract

Regional anesthesia is a rapidly expanding field within the practice of anesthesiology. The use of peripheral nerve blocks in routine anesthesia care has increased as evidence for better analgesia, and decreased opioid consumption has supported this practice. This chapter highlights several cutting-edge trends within the arena of regional anesthesia. Fascial plane blocks involve the deposition of local anesthetic between fascial planes without targeting a specific nerve; this chapter discusses several new plane blocks, including quadratus lumborum, pectoral, serratus, and erector spinae plane blocks. Furthermore, the advent of ultrasound has allowed visualization of nearby structures and performance of blocks that otherwise may have too low of a safety margin without visualization. This chapter will discuss some of these blocks, such as parasternal and IPACK (interspace between the popliteal artery and capsule of the posterior knee) blocks. Finally, the chapter will summarize evidence behind the use of long-acting local anesthetic drugs as well as innovative ergonomics as a means to improve our work processes.

Keywords

Regional anesthesia Local anesthetic Fascial plane block Nerve block Quadratus lumborum block Serratus plane block Pectoral nerve block Parasternal block Erector spinae block Regional anesthesia ergonomics 

Abbreviations

Cm

Centimeters

IPACK

Interspace between the popliteal artery and the capsule of the knee

PACU

Postanesthesia care unit

PECS

Pectoral nerve block

QL

Quadratus lumborum

TAP

Transversus abdominis plane

TKA

Total knee arthroplasty

TTP

Transversus thoracic muscle plane

Supplementary material

Video 39.1

Single-operator ultrasound-guided perineural catheter insertion. With this grip, the operator can control both the needle and catheter positions, and advance or retract the catheter, while maintaining an appropriate sonographic image using the other hand (MOV 34408 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyDuke University Medical CenterDurhamUSA

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