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Category: Injection Procedures

The injection procedures outlined in this chapter are appropriately used in conjunction with other aspects of rehabilitation to reduce pain and increase function. Sterile technique and knowledge of anatomic relationships are required. Aspiration is performed before injecting and is repeated as necessary throughout administration of medication to prevent intravascular injection. For optimal results and safety with injection techniques, the practitioner needs the necessary skill, training, and education to perform the procedures. Haste and failure to observe the necessary precautions by the practitioner increase the risks for any procedure. Knowledge of the anatomy pertaining to each injection procedure is a requirement for safe and successful outcomes in even the simplest injection.

Common Peroneal Nerve Block At The Knee

Common Peroneal Nerve Block At The Knee

Tiếng Việt >> Indications Common peroneal nerve blockade is useful as a diagnostic, prognostic, or therapeutic procedure in painful disorders involving the ankle and foot. Techniques After informed consent is obtained, the patient is placed in the supine or lateral position. The common peroneal nerve can be easily palpated as it crosses the neck of the fibula. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is…

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Tibial Nerve Block At The Knee

Tibial Nerve Block At The Knee

Tiếng Việt >> Indications Tibial nerve blockade is useful as a diagnostic, prognostic, or therapeutic procedure in painful disorders involving the ankle and foot. Techniques After informed consent is obtained, the patient is placed in the prone position. The knee is flexed to allow palpation of the superior popliteal fossa borders and identification of the skin crease behind the knee joint. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks,…

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Sciatic Nerve Block

Sciatic Nerve Block

Tiếng Việt >> Indications Sciatic nerve blockade is typically used to treat painful conditions of the lower leg such as complex regional pain syndrome and to facilitate physical therapy by decreasing pain in the lower extremity. Techniques A regional block of the sciatic nerve can be achieved anywhere along the course of the nerve. Most of the approaches have been developed mainly to avoid positioning problems that may be present in trauma patients or elderly people. The nerve can be…

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Obturator Nerve Block

Obturator Nerve Block

Tiếng Việt >> Indications Obturator nerve blockade is extremely useful as a diagnostic, prognostic, or therapeutic procedure in patients with adductor spasm that interferes with rehabilitation or personal hygiene. Techniques After informed consent is obtained, the patient is placed in the supine position with the leg to be blocked placed in slight abduction. It is not necessary to shave the pubic area. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of…

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Femoral Nerve Block

Femoral Nerve Block

Tiếng Việt >> Indications Femoral nerve blockade is useful in conjunction with other lower extremity blocks in treating complex regional pain syndrome and as an aid to decrease knee and ankle pain during physical therapy. Techniques After informed consent is obtained, the patient is placed in the supine position, and the femoral artery is located. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout…

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Lateral Femoral Cutaneous Nerve Block

Lateral Femoral Cutaneous Nerve Block

Tiếng Việt >> Indications Lateral femoral cutaneous nerve blockade is useful for diagnosing and treating pain in the lateral thigh, thought to be from irritation of this nerve. Techniques After informed consent is obtained, the patient is placed in a supine position, and the anterosuperior iliac spine is palpated. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. A 1½-in. (4-cm), 21-…

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Caudal Injection

Caudal Injection

Tiếng Việt >> Indications The caudal approach to the epidural space is used to treat pain in the lower back and pelvis. Techniques After informed consent is obtained, the patient may be placed in a variety of positions, with patient comfort probably as the prime concern. The preferred position is the lateral Sims’ position with the left side down for right-handed clinicians. With the upper leg flexed, the buttocks are separated, allowing easy access to the sacral-coccygeal junction. The patient…

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Lumbar Sympathetic Block

Lumbar Sympathetic Block

Indications Lumbar sympathetic blockade is useful for diagnosing and treating pain of sympathetic origin. This includes pain involving the pelvis and lower extremity, secondary to complex regional pain syndrome, vasospastic disorders, and phantom pain. Techniques The spinous process of the second or third lumbar vertebra is palpated, and a point is marked 4 cm lateral to the middle of the spinous process. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of…

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Lumbar Epidural Steroid Injection

Lumbar Epidural Steroid Injection

Tiếng Việt >> Indications ESI is most effective for lumbosacral radiculopathy associated with intervertebral disc herniation, bulging, or degeneration. The main criterion for success is the presence of nerve root inflammation that can be relieved by the steroid. ESI also has been used to treat pain from degenerative joint disease, scoliosis, spondylolysis, spondylolisthesis, postlaminectomy syndrome, facet abnormalities, herpes zoster, and postherpetic neuralgia. Techniques After informed consent is obtained, the patient is placed prone, lateral decubitus, or sitting with the back,…

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Celiac Plexus Block

Celiac Plexus Block

Indications Celiac plexus blockade is useful for diagnosing and treating pain of sympathetic origin. This includes pain involving the viscera, abdomen, and pelvis, secondary to cancer, complex regional pain syndrome, and vasospastic disorders. Techniques After informed consent is obtained, the patient is placed in the prone position with a pillow under the abdomen. The inferior edge of the spinous process of the first lumbar vertebra and the lower border of each 12th rib at 7 cm from the spinous process…

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