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blocks, that's sufficient.
3. Adductor canal. Providers used to place a femoral nerve
block for knee surgeries. Today, we perform the adductor canal
block, which is a more selective block in the femoral triangle to
minimize motor weakness. Again, members of your anesthesia
team should know how to place a femoral or an adductor canal
block. Either provides pain relief for major knee surgeries, and
knowing how to do one of these is a springboard to expand your
practice should you decide to perform more advanced blocks.
4. Popliteal sciatic. Anesthesia practitioners should be able to
identity the sciatic nerve behind the knee in the popliteal fossa. A
popliteal sciatic block provides great pain relief for foot and ankle
surgeries, which are common procedures in outpatient settings.
5. Transversus abdominis plane (TAP). A TAP block is the most
common interfascial plane block for abdominal and pelvic sur-
geries. It can be performed quickly in the operating room and
provide somatic abdominal wall analgesia for outpatients having
minor surgeries such as inguinal hernia repair or laparoscopy.
When more anesthesia practitioners know how to use these
techniques, attitudes will change about the effectiveness of region-
al anesthesia and barriers to implementing the pain-relieving prac-
tice into clinical pathways will be addressed, including differing
opinions on how much patients benefit from their use and how
practical the techniques are to implement. Concerns about liability
and cost persist as well. It's my hope that improving research,
sharing best practices and increasing awareness of the benefits of
these blocks will remove those obstacles.
— Edward R. Mariano, MD, MAS
