Agree that '3-in-1' blocks usually work very well (Initially taught to me by
Ffion Davies) but occasional disappointing results despite seeming OK when
you do them. Our SHOs now doing them for fractured NOFs.
When I've seen Anaesthetists do them with a nerve locator before elective
arthroplasty for osteoarthritis they have also given the patient a slug of
propofol to tolerate an uncomfortable couple of minutes twitching. You would
expect any discomfort to be much worse with a fracture.
Is the technique different?
Do you use your nerve locator for axillary/ ulnar/ median nerve blocks?
Ultrasound sounds great - 'ensuring that you get the local all around the
nerve'
Are you describing a technique for instilling around the femoral nerve for a
block or into the facial plane for '3-in-1' block ? (or either?)
How good does your musculo-skeletal ultrasound need to be?
James Cameron
----- Original Message -----
From: "Dunn Matthew Dr. (RJC) A & E - SwarkHosp-TR"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, March 29, 2006 11:46 AM
Subject: Re: fascia iliaca block for hip fractures
>> Wheras I am ever eager to learn new stuff, I was keener to
>> get stimulator controlled femoral block embedded. I have just
>> got my first two boxes of needles!
>
>
> On a little technical point, a nerve stimulator is for checking adequacy
> or
> neuromuscular block. I think it's a nerve locator that you're looking for.
> Using ultrasound guidance to put in the block has the advantage of being
> cheaper (in terms of disposables or if you've already got a machine with a
> linear array probe), causing less discomfort to the patient and ensuring
> that you get the local all around the nerve.
>
> Matt Dunn
> Warwick
>
>
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