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Anesthetic techniques: reGionAl ● 189 Figure 13.8 Interscalene nerve block. (Reproduced with permission from Twersky, R and Philip, B. Handbook of Ambulatory Anesthesia. Springer, 2008). Supraclavicular Block A supraclavicular PNB is an excellent choice for surgery of the arm or hand. Once the interscalene groove is palpated, the groove is followed down the neck to the clavicle. Approximately 1 cm above the clavicle is the insertion point for the block needle. Under ultrasound guidance, the brachial plexus appears as a “cluster of grapes” lateral to the subclavian artery. Again, 25–40 mL of local anesthetic may be administered. The most common serious complication is pneumothroax, which can occur in 1% of cases. Infraclavicular Block An infraclavicular PNB is a good block for surgery of the lower arm and hand. As the brachial plexus passes under the clavicle, the plexus forms three cords surrounding the axillary artery. The nerve block needle is further removed from the pleura and the neuraxis and the risk of pneumothorax or neuraxial anesthesia is low. There are several approaches to the infraclavicular PNB. The most common approach is to identify the midpoint of the clavicle and a line is drawn 2–3 cm caudad from this point. The nerve block needle is then directed
190 ● AnesthesiA student survivAl Guide Figure 13.9 Innervation of the foot. Plantar surface: 1. Saphenous nerve; 2. Deep peroneal nerve; 3. Superficial peroneal nerve; 4. Medial planar nerve. Dorsal surface: 5. Lateral plantar nerve; 6. Tibial nerve (calcaneal branch); 7. Sural nerve. (Image Courtesy J. Ehrenfeld). at a 45 angle towards the axilla. A motor response with nerve stimulation is usually sought in the hand with a current
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Anesthesia Student Survival Guide
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Editors Jesse M. Ehrenfeld, MD, MPH
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Foreword As anesthesiologists and H
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Contents Case Studies xvii Section
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ContEntS ● xi 19 Physiology and A
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Contributors Basem Abdelmalak, MD S
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David C. Lai, MD Partner, Allenmore
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CASE STUDIES In order to focus your
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CASE StUDIES ● xix inhalation ane
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CASE StUDIES ● xxi around the job
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CASE StUDIES ● xxiii ● Although
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CASE StUDIES ● xxv ● You plan a
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CASE StUDIES ● xxvii ● What oth
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CASE StUDIES ● xxix Chapter 23 Ca
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CASE StUDIES ● xxxi of her left h
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CASE StUDIES ● xxxiii speechless.
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CASE StUDIES ● xxxv things go ver
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How to Be a “Star” Student, Car
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hOw tO Be A “stAr” student, CAr
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Pre-Op Holding Area Preoperative Ev
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History of Anesthesia and Introduct
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history of AnesthesiA And introduct
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Pharmacology Section II
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30 ● AnesthesiA student survivAl
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The Preoperative Patient Evaluation
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THe PreoPerATIve PATIenT evAluATIon
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Therapy-based indications radiation
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Table 8.5 Formulation an anesthetic
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Anesthesia Equipment and Monitors B
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AnesthesiA eQuiPment And mOnitOrs
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Page 190 and 191: Table 12.2 Stages of general anesth
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Page 200 and 201: Anesthetic Techniques: Regional Ant
Page 202 and 203: Figure 13.2 Surface anatomy for neu
Page 204 and 205: Table 13.1 Risks of neuraxial anest
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Page 234 and 235: Table 14.6 Advantages, disadvantage
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iv, GAstric tube, ArteriAl & centrA
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Common Intraoperative Problems Fran
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Pneumothorax Uncommon, but may spon
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COMMON INTRAOPERATIVE PROBLEMS ●
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Table 16.3 Common intraoperative dy
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Table 16.3 (continued) Problem Diff
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Systems Physiology and Anesthetic S
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Chapter 20 Physiology and Anesthesi
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PhysioloGy And AnesthesiA for Gener
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Anesthesia for Urological Surgery P
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AnesthesiA for uroloGicAl surGery
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Physiology and Anesthesia for Pedia
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PhysioloGy And AnesthesiA for PediA
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Table 22.6 Common pediatric emergen
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Physiology and Anesthesia for Elder
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PhysioloGy And AnesthesiA for elder
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Chapter 24 Ambulatory Surgery and O
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AmbulAtOry Surgery ANd Out-Of-Or (O
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Perioperative Acute and Chronic Pai
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PerioPerAtive ACute And ChroniC PAi
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Chapter 27 Postoperative Anesthesia
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POstOPerAtive AnesthesiA CAre unit
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Introduction to Critical Care Bever
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introduction to criticAl cAre ● 4
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SVR = [(MAP - CVP)/CO] ´ 80 introd
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● ● ● ● ● introduction to
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Chapter 29 Professionalism, Safety,
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ProfessionAlism, sAfety, And teAmwo
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Chapter 30 Quality Assurance, Patie
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QuAlity AssurAnce, PAtient And Prov
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Chapter 32 Clinical Simulation in A
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Table 32.1 Matrix of categories of
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CliniCAl simulAtion in AnesthesiA e
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ASA Difficult Airway Algorithm Appe
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518 ● ANESTHESIA STUDENT SURVIVAL
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