True, shoulder arthro-
scopies and replace-
ments, total knees and
ACL repairs, and open
reduction interal fixa-
tion (ORIF) blocks of
an ankle or wrist are
all procedures where
nerve blocks should
be the standard. But
there are many other
procedures where pre-
cise and safe ultra-
sound-guided regional
anesthesia can greatly
benefit the patient.
Here are just a few
examples:
• PECS I and II
blocks for breast
reconstruction,
cosmetic surgery and chest wall procedures.
• TAP blocks for hernia repairs and abdominoplasties.
Another exciting development is the adoption of newer blocks —
adductor canal, quadratus lumborum and iPACK — and newer
approaches to old blocks such as the way some providers are placing
infraclavicular blocks. The retroclavicular approach to the infraclavic-
ular region (also known as RAPTIR block) prevents the steep angle of
needle-to-ultrasound ratio seen in the traditional coracoid approach.
This makes needle visualization easier and eliminates the need to
8 0 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 2 0
TRUE BELIEVER Dr. Durick had his rotator cuff arthroscopically repaired and woke
up pain-free because of the effects of ultrasound-guided regional anesthesia.
