Topographic Anatomy and Physiologic Considerations

Abstract

Abstract The ability to select the optimal regional technique requires a detailed understanding of anatomy and local anesthetic properties. Anatomic knowledge must include gross surface anatomy as it corresponds with neurologic innervation and include basic neurologic anatomy. Further, neuraxial blocks require an intricate knowledge of the dermatomal distribution where analgesia is needed, combined with the posterior anatomic landmarks that will guide correct needle placement to deliver targeted analgesia. In the same way, comprehension of peripheral nerve and plexus anatomy is also needed to ensure that anesthetic coverage is maximized and analgesia optimized during placement of plexus, peripheral nerve block, or fascial blocks. Similarly, various factors may impact both the onset and duration of neuraxial and peripheral techniques. In this regard, comprehension of local anesthetic characteristics, basic nerve properties, and the risks and benefits of different regional techniques is needed. Ultimately the regional technique, local anesthetic type, and local anesthetic dose and volume will depend on patient factors and procedure factors.