RASCI - Live Nerve Block Demos
This has been found to be an exceptionally effective teaching tool. Live sharp needle demonstrations have been a tradition at the University of Iowa since 2000 when started by Dr. Andre Boezaart.
The models are non-sedated and only receive subcutaneous lidocaine (lignocaine) to diminish the discomfort of dermis puncture with nerve-block needles.Deeper tissues are non-anesthetized and no other drugs are injected except for 5% dextrose water for ultrasound imaging purposes. To date, 100% of models used request to be a model again and no complication of note has ever occurred.
This reality show demonstration presents real challenges, and seeing the lecturer's need to concentrate and adapt to unexpected unique anatomy variations in front of an audience has added educational value. Also seeing real live nerve blocks closes the gap between some hard to explain concepts and complete understanding of ideas.
Visual images are retained longer in the memory than mental images created from words only.
The live sharp needle demonstration also validates the lecturer is speaking from personal experience and not hypothetical text book knowledge.
A picture paints a thousand words in 2-D. A live demonstration paints a million words in 3-D.
There are enumerable nerve block approaches and variations. Some are sensible and other less so. Some are only good in the hands of its "prophet"-teacher, but hard to master for the average occasional regional anesthesiologist.
The selected nerve blocks highlighted in this course are chosen for their relative ease of performing, ease of learning and common useful applications. All variations can be discussed during the course if requested. Time restraint however will only allow live demonstration of the following nerve blocks. Special request demonstrations of other blocks or approaches may be performed. Discuss this with the course director beforehand.
Upper limb peripheral nerve blocks
- Interscalene block with surface nerve mapping.
- Interscalene block single shot ultrasound-guided. [needle block]
- Interscalene block posterior approach, perineural catheter placement, ultrasound- guided (this replaces the former cervical paravertebral nerve stimulator guided block). [needle block]
- Supraclavicular block single shot [needle block]
- Infraclavicular nerve block by the superior cord approach (European lateral infraclavicular block) single shot nerve stimulator guided. [needle block]
- Infraclavicular nerve block by the superior cord approach (European lateral infraclavicular block) perineural catheter ultrasound guided. [needle block]
- Axilla blocks, elbow, forearm and wrist blocks - ultrasound demonstration only
LOWER LIMB BLOCKS
- Femoral nerve with surface nerve mapping.
- Femoral nerve perineural catheter placement ultrasound guided [needle block]
- Obturator erve - nerve stimulator guided [needle block]
- Obturator nerve - ultrasound guided proximal approach [demonstration]
- Sciatic nerve - popliteal fossa ultrasound guided [needle block]
- Sciatic nerve - transgluteal nerve single shot (GT-IT line approach) ultrasound guided [needle block]
- Sciatic nerve - transgluteal nerve (GT-IT line approach) perineural catheter ultrasound guided. [needle block time permitting]
- Saphenous nerve, single shot distal trans-sartorius approach, ultrasound guided [needle block]
- Lateral cutaneous nerve of the thigh ultrasound guided [needle block]