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Peripheral Nerve Blocks

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78 views14 pages

Peripheral Nerve Blocks

Uploaded by

a.parveez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Peripheral nerve

blocks
Hannah Lovatt

derby.ac.uk/
online
What are peripheral nerve blocks?

• An injection of local anaesthetic around (not into!) a nerve to numb a specific part
of the body

• It can be performed as a stand alone procedure, or in conjunction with other


anaesthetic techniques such as sedation or general anaesthesia

• Dependent on site of anaesthesia, the numbing/analgesic effects can last from 2-


18 hours

Association of Anaesthetists (AoA) (2021); Royal College of Anaesthetists (RCoA) (2016)

derby.ac.uk/
online
What peripheral blocks have you seen in your area?

derby.ac.uk/
online
Examples of peripheral nerve blocks

Image: www.sciencedirect.com derby.ac.uk/


online
What equipment do you need?

derby.ac.uk/
online
Equipment required

• Ultrasound machine, probe cover


• Needles – in a range of lengths, specific for performing peripheral block, e.g.
Stimuplex
• Local anaesthetic (e.g. levobupivacaine), syringes and needles to draw up
• Chlorhexidine spray
• Nerve stimulator (although not considered to improve success of block)
• Patient monitoring equipment
• Equipment for conversion to general anaesthetic (if this is not already being
performed)
• Emergency equipment

AoA (2021)
derby.ac.uk/
Image: www.healthcare-in-Europe.com online
Image: www.grepmed.com

derby.ac.uk/
online
Stop Before You Block/Prep Stop Block

• Initiative designed to reduce wrong site block

• “Stop Before You Block” has been revised since it


was first introduced in 2011, as incidences of wrong
site block were still high

Safe Anaesthesia Liaison Group (SALG) (2021)


Image: www.salg.ac.uk

derby.ac.uk/
online
NR Fit system

• Compatible syringe/needle system developed to replace the use of Luer syringes


in both regional and neuraxial anaesthesia
• Designed to reduce accidental injection of IV medication during these procedures,
which has resulted in patient morbidity and mortality
• Use of the NR fit system is becoming the standard practice in healthcare

Braun (2023)
Images: www.bbraun.co.uk

derby.ac.uk/
online
What are the risks of a peripheral nerve block?

derby.ac.uk/
online
Risks of peripheral nerve block

• Nerve damage – short term or permanent


• Haematoma
• Infection
• Ensure procedure is performed aseptically to reduce the risk of this
• Accidental injection into vein/artery
• …if significant enough can cause bradycardia, hypotension, arrhythmias, respiratory
depression, cardiorespiratory arrest.
• Ensure you know where the lipid emulsion/intralipid is kept on your department
• Pneumothorax (depending on site)
• Shortness of breath, desaturation

RCoA (2016)

derby.ac.uk/
online
To summarise…

• The role of the ODP is to contribute to regional anaesthesia being performed


safely and at the correct site
• Assist the anaesthetist in setting up equipment, and to support the patient
physically and psychologically, if required.
• To monitor the patient throughout and post-administration of regional anaesthesia,
being mindful of potential complications, throughout surgery until transfer to
recovery
• To know the location of emergency equipment should it be needed

derby.ac.uk/
online
University of Derby, Kedleston Road, Derby, DE22 1GB
T +44 (0)1332 591044 E opendays@derby.ac.uk

derby.ac.uk/online
References

Association of Anaesthetists (2021) The role of peripheral nerve stimulation in the era
of ultrasound-guided regional anaesthesia. Available at: www.anaesthetists.org
(Accessed: 6th March 2023).
Braun (2023) Reducing Risks of Misconnections in Regional Anaesthesia. Available
at: www.bbraun.co.uk (Accessed: 6th March 2023).
Royal College of Anaesthetists (2016) Nerve damage associated with peripheral
nerve block. Available at: www.rcoa.ac.uk (Accessed: 6th March 2023).
Safe Anaesthesia Liaison Group (2021) Stop Before You Block. Available at:
www.salg.ac.uk (Accessed: 6th March 2023).

derby.ac.uk/
online

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