Four Important Blocks of The Last Decade

Vol 2 | Issue 1 | January-June 2021 | Page 54-62 | J Balavenkatasubramanian, Gurumoorthi Palanichamy, Senthil Kumar Balasubramanian, Madhanmohan Chandramohan, Vinoth Kumar Subramanian, Satish Raja Selvam Parameswaran

Authors: J Balavenkatasubramanian [1], Gurumoorthi Palanichamy [1], Senthil Kumar Balasubramanian [1], Madhanmohan Chandramohan [1], Vinoth Kumar Subramanian [1], Satish Raja Selvam Parameswaran [3]

[1] Department of Anaesthesia, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. Gurumoorthi Palanichamy, Ganga Hospital, Coimbatore, Tamil Nadu, India.
E-mail: drpgurumoorthi@gmail.com

Introduction

Ultrasonography (USG) guided regional anaesthesia has become the standard practice due to its improved success rate and decreased complications. With the advent of USG regional anaesthesia has flourished in a way that every surgery can be supplemented with a regional block as a part of multimodal analgesia. USG guided regional anaesthesia became rampant in the last decade with many newer inter-fascial plane blocks involving the paraspinal, chest wall and abdominal wall being introduced. Also new approaches for the plexus blocks are being established with improved safety and success. Here in this educational article, we are discussing the intricacies of the USG guided Costoclavicular approach of brachial plexus block, PEricapsular Nerve Group (PENG) block, Serratus Plane block (SPB) and Supra inguinal Fascia Iliaca Block (SIFICB). The costoclavicular approach for brachial plexus block is phrenic nerve sparing and still consistently block all the nerves arising from the cords, making it a safer option in certain population of patient with respiratory compromise. PENG block was introduced in the last decade for providing analgesia for the hip orthopedic procedures and advantage of this block is that there is no motor involvement without any major complications. The SPB is a one of chest wall block used for providing analgesia to the anterolateral chest especially for breast surgery and pain management in rib fractures. Being superficial and technically easier using USG, SPB has been included in the standard pain management for chest trauma. USG guided SIFICB introduced was introduced in 2011 as a novel approach to block the major nerves of lumbar plexus anteriorly but it gained popularity in the recent past for its ability to block femoral nerve, lateral femoral cutanoues nerve and possibly obturator nerve. With this block the above mentioned nerves can be blocked easily without any complications of classical approach for lumbar plexus block.

1- Costoclavicular Brachial Plexus Block– A Phrenic Nerve Sparing Novel Block

2- Serratus Plane Block

3-  PENG [PEricapsular Nerve Group] Block

4- Suprainguinal Fascia Iliaca Block– Is It The True 3 In 1 Block?

References

Costoclavicular Brachial Plexus Block– A Phrenic Nerve Sparing Novel Block
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Serratus Plane Block
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PENG [PEricapsular Nerve Group] Block
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Suprainguinal Fascia Iliaca Block– Is It The True 3 In 1 Block?
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5. Singh, Harsimran, Jones, David. Hourglass-Pattern Recognition Simplifies Fascia Iliaca Compartment Block. Reg Anesth Pain Med. 2013;38(5):467-8. doi:10.1097/AAP.0b013e3182a1f772.

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