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