Equipment

The Ultrasound

  • Ultrasound machine
  • High-frequency linear transducer
  • Sterile ultrasound sheath & sterile ultrasound gel

 

The Sterile Field

  • Cleaning solution (chlorhexidine, alcohol or betadine)
  • Sterile towels & gauze packs
  • Marking pen
  • Personal protective equipment (gloves, gown, mask and hairnet)

 

The Nerve Block

For the superficial local anesthetic

  • One 25G 0.5-inch needle (for superficial local anesthetic injection)
  • 1% Lidocaine (2-3 mL in 5mL syringe)

 

For the femoral nerve block

  • One echogenic needle (e.g., Pajunk 22G or 21G needle, if available)
  • One 22G spinal needle (if echogenic needle unavailable)
  • One IV-adaptor (to aid in aspiration/injection)
  • Local anesthetic (drawn up in a 20mL syringe)
    • For anesthetic considerations see table
    • Note: maximum anesthetic volume 25mL for all patients
Local Anesthetic (no epi) Onset Duration Recommended Dose Max Dose Notes
 

Lidocaine

 

5-15mins

 

2-5hrs

 

4mg/kg

(0.4mL/kg of 1%)

 

5 mg/kg

(0.5mL/kg of 1%)

 

 

1%: 10mg/mL

2%: 20mg/ml

 

 

Bupivacaine

 

15-40mins

 

6-10hrs

 

1.5 mg/kg

(0.6mL/kg of 0.25%)

 

2.5 mg/kg

(1mL/kg of 0.25%)

 

 

0.25%: 2.5mg/mL

 

 

Ropivacaine

 

 

15-40mins

 

5-9hrs

 

1.5mg/mg

(0.8mL/kg of 0.25%)

 

3 mg/kg

 

0.25% 2.5mg/mL

 

Table 3: Anesthetic Considerations