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Compendium of Regional Anesthesia

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  1. Foundations
    1. Histology of peripheral nerves and light microscopy
    14 Topics
  2. 2. Functional Regional Anesthesia Anatomy
    20 Topics
  3. 3. Local Anesthetics: Clinical Pharmacology and Selection
    31 Topics
  4. 4. Multimodal Analgesia: Pharmacologic Interventions and Prevention of Persistent Postoperative Pain
    10 Topics
  5. 5. Equipment for Peripheral Nerve Blocks
    16 Topics
  6. 6. Electrical Nerve Stimulation
    18 Topics
  7. 7. Optimizing an Ultrasound Image
    7 Topics
  8. 8. Indications for Peripheral Nerve Blocks
    6 Topics
  9. 9. Regional Anesthesia & Nerve Injury
    3 Topics
  10. 10. Assessment of Neurologic Complications of Regional Anesthesia
    10 Topics
  11. 11. Local Anesthetic Systemic Toxicity and Allergy to Local Anesthetics
    18 Topics
  12. Head and Neck Nerve Blocks
    12. Nerve Blocks of the Face
    13 Topics
  13. 13. Regional and Topical Anesthesia for Awake Endotracheal Intubation
    11 Topics
  14. 14. Regional Anesthesia for the Eye
    13 Topics
  15. 15. Ultrasound-Guided Cervical Plexus Block
    11 Topics
    |
    1 Quiz
  16. Neuraxial Anesthesia and Other Special Techniques
    16. Neuraxial Anatomy
    9 Topics
  17. 17. Spinal anesthesia
    11 Topics
  18. 18. Epidural anesthesia
    15 Topics
  19. 19. Combined Spinal-Epidural Anesthesia
    23 Topics
  20. 20. Caudal Anesthesia
    12 Topics
  21. 21. Pediatric Spinal Anesthesia & Analgesia
    8 Topics
  22. 22. Pediatric Epidural Anesthesia & Analgesia
    21 Topics
  23. 23. Mechanisms and management of failed spinal anesthesia
    7 Topics
  24. 24. Postdural Puncture Headache
    35 Topics
  25. 25. Diagnosis and Management of Spinal and Peripheral Nerve Hematoma
    9 Topics
  26. 26. Intravenous regional anesthesia for upper and lower extremity
    7 Topics
  27. 27. Intra-articular and Periarticular Infiltration of Local Anesthetics
    8 Topics
  28. Blocks for the Upper Extremity
    28. Interscalene Brachial Plexus Block
    9 Topics
    |
    1 Quiz
  29. 29. Supraclavicular Brachial Plexus Block
    9 Topics
    |
    1 Quiz
  30. 30. Infraclavicular Brachial Plexus Block
    9 Topics
    |
    1 Quiz
  31. 31. Costoclavicular Brachial Plexus Block
    7 Topics
  32. 32. Shoulder Block
    10 Topics
    |
    1 Quiz
  33. 33. Axillary Brachial Plexus Block
    9 Topics
    |
    1 Quiz
  34. 34. Nerve Blocks Above the Elbow
    9 Topics
  35. 35. Wrist Block
    10 Topics
    |
    1 Quiz
  36. Nerve Blocks for the Lower Extremity
    36. Sonography of the Lumbar Paravertebral Space and Considerations for Ultrasound-Guided Lumbar Plexus Block
    4 Topics
  37. 37. Fascia Iliaca Block
    9 Topics
    |
    1 Quiz
  38. 38. The Hip Block
    8 Topics
  39. 39. Femoral Nerve Block
    9 Topics
    |
    1 Quiz
  40. 40. Saphenous Nerve Block at the Adductor Canal
    8 Topics
  41. 41. Popliteal Sciatic Nerve Block
    9 Topics
    |
    1 Quiz
  42. 42. IPACK Block
    9 Topics
  43. 43. Ankle Block
    13 Topics
    |
    1 Quiz
  44. 44. Tibial Nerve Block at the Level of the Ankle
    8 Topics
  45. 45. Deep peroneal nerve block at the level of the ankle
    8 Topics
  46. 46. Superficial Peroneal Nerve Block at the Level of the Ankle
    8 Topics
  47. 47. Sural Nerve Block at the Level of the Ankle
    8 Topics
  48. 48. Saphenous Nerve Block at the Level of the Ankle
    8 Topics
  49. 49. Genicular Nerve Blocks
    13 Topics
  50. Abdominal & Thoracic Wall Blocks
    50. Pectoralis and Serratus Anterior Plane Blocks
    11 Topics
    |
    1 Quiz
  51. 51. Transversus Abdominis Plane (TAP) Blocks
    11 Topics
    |
    1 Quiz
  52. 52. Quadratus Lumborum Plane Blocks
    10 Topics
    |
    1 Quiz
  53. 53. ESPB
    8 Topics
  54. 54. Rectus Sheath Block
    9 Topics
  55. 55. Paravertebral Block
    8 Topics
  56. RA for Specific Surgical Procedures
    56. Carpal Tunnel Release
    2 Topics
  57. 57. Total Shoulder Arthroplasty
    2 Topics
  58. 58. Total Hip Arthroplasty
    2 Topics
  59. 59. Total Knee Arthroplasty
    2 Topics
  60. RA in Patients with Specific Considerations
    60. Obstetric Regional Anesthesia
    31 Topics
  61. 61. Regional Anesthesia & Cardiovascular Disease
    16 Topics
  62. 62. Perioperative Regional Anesthesia in the Elderly
    14 Topics
  63. 63. Regional Anesthesia in Patients with Trauma
    12 Topics
  64. 64. Regional Anesthesia in Anticoagulated Patients
    5 Topics
  65. 65. ERAS Protocols
Lesson 53, Topic 3
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53.3 Sensory & motor block

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Mechanisms of nerve block and distribution of the local anesthetic are not consistent.

Studies suggest that local anesthetic after ESPB spreads in a cephalocaudal distribution, reaching mainly the dorsal rami and rarely the ventral ramus of the spinal nerves, and intercostal spaces. Distribution into the paravertebral space, and sympathetic chain is questionable. 

Sensory distribution of an ESPB comprising block of the dorsal rami. These rami carry visceral motor, somatic motor, and sensory information to and from the skin and deep muscles of the back. The extent of the block and its analgesic efficacy is variable due to the variability in the craniocaudal distribution of the local anesthetic.