Regional Anesthesia Upper and Lower Extremity Guide Dec 2018

Regional Anesthesia Upper Extremity Axillary approach

3

4

Transverse section of axillary canal

8

Anterior

1 Median nerve 4

2 Ulnar nerve

1

2 5

3 Axillary nerve 6

4 Musculocutaneous

nerve 5 Medial cutaneous 8

1

nerve of arm

2 8

6 Medial cutaneous

Lateral

Medial Anterior view

7

nerve of forearm 7 Radial nerve

Posterior

8 Artery / Vein

Posterior view

Reference J.-J. Eledjam: M.D.; PH.D Professor of University Hospital, Nimes | Dr. B. Bassoul: MD; Clinique Beau Soleil, Montpellier | Dr. J. Teissier: MD; DESC Surgery Orthopedics, Montpellier

Motor response to musculocutaneous nerve stimulation

1

2

1 | Stimuplex® HNS 12 2 | Contiplex® S Ultra 360, Stimuplex® Ultra 360, Contiplex® Tuohy Ultra 360

Motor response to median nerve stimulation 1 | Wrist flexion 2 | Fingers’ flexion 3 | Thumb opposition

Motor response to ulnar nerve stimulation 1 | Ulnar deviation of the wrist 2 | Metacarpo-phalangeal flexion 3 | Thumb adduction

Motor response to radial nerve stimulation 1 | Wrist extension 2 | Metacarpo-phalangeal extension 3 | Thumb adduction

3

3 | Stimuplex® Pen

Infiltration of the medial cutaneous nerve of the arm and the forearm

B. Braun Melsungen AG | Hospital Care | 34209 Melsungen | Germany Tel. +49 5661 71-0 | www.bbraun.com Date of last revision: 12.2018

Regional Anesthesia Lower Extremity Sciatic Nerve Block: Posterior Approach

Tibial nerve Posterior cutaneous nerve of thigh

Cross section of upper leg at level of head of femur

Medial plantar nerve Lateral plantar nerve

Femoral vein and artery

Sural nerve

Femoral nerve Psoas muscle

Common peroneal nerve

Head of femur

Lateral cutaneous nerve of calf

Greater trochanter Acetabulum

Superficial peroneal nerve

Sciatic nerve

Deep peroneal nerve

Gluteus maximus muscle

Reference J.-J. Eledjam: M.D.; PH.D Professor of University Hospital, Nimes | Dr. B. Bassoul: MD; Clinique Beau Soleil, Montpellier | Dr. J. Teissier: MD; DESC Surgery Orthopedics, Montpellier

Foot in neutral position

Motor response to tibial nerve stimulation 1 | Plantar flexion of foot and toes 2 | Inversion of foot

Motor response to deep peroneal nerve stimulation

Motor response to superficial peroneal nerve stimulation 1 | Abduction of foot 2 | Eversion of foot

Classical position

1

2

1 | Stimuplex® HNS 12 2 | Contiplex® S Ultra 360, Stimuplex® Ultra 360, Contiplex® Tuohy Ultra 360

3

4

3 | Stimuplex® Pen 4 | Stimuplex® HNS compact

Recommended position 1 | Posterior superior iliac spine 2 | Greater trochanter

3 | Sacral hiatus

B. Braun Melsungen AG | Hospital Care | 34209 Melsungen | Germany Tel. +49 5661 71-0 | www.bbraun.com Date of last revision: 12.2018

Regional Anesthesia Lower Extremity Sciatic Nerve Block: Posterior Approach

Tibial nerve Posterior cutaneous nerve of thigh

Cross section of upper leg at level of head of femur

Medial plantar nerve Lateral plantar nerve

Femoral vein and artery

Sural nerve

Femoral nerve Psoas muscle

Common peroneal nerve

Head of femur

Lateral cutaneous nerve of calf

Greater trochanter Acetabulum

Superficial peroneal nerve

Sciatic nerve

Deep peroneal nerve

Gluteus maximus muscle

Reference J.-J. Eledjam: M.D.; PH.D Professor of University Hospital, Nimes | Dr. B. Bassoul: MD; Clinique Beau Soleil, Montpellier | Dr. J. Teissier: MD; DESC Surgery Orthopedics, Montpellier

Foot in neutral position

Motor response to tibial nerve stimulation 1 | Plantar flexion of foot and toes 2 | Inversion of foot

Motor response to deep peroneal nerve stimulation

Motor response to superficial peroneal nerve stimulation 1 | Abduction of foot 2 | Eversion of foot

Classical position

1

2

1 | Stimuplex® HNS 12 2 | Contiplex® S Ultra 360, Stimuplex® Ultra 360, Contiplex® Tuohy Ultra 360

3

Recommended position

3 | Stimuplex® Pen

1 | Posterior superior iliac spine 2 | Greater trochanter

3 | Sacral hiatus

B. Braun Melsungen AG | Hospital Care | 34209 Melsungen | Germany Tel. +49 5661 71-0 | www.bbraun.com Date of last revision: 12.2018