Blockade of a lumbar texture

Description:

Indications:

    * Postoperative anesthesia at pathology of a knee joint of average and high complexity.
    * Patella fracture, rupture of a sinew four-head of a muscle, arthroscopy of a knee joint. As a monomethod or in combination with other methods, for out-patient operations on a back crucial ligament of a knee.
    * Full prosthetics of a knee joint as a monomethod, and in combination with blockade of a sciatic nerve, single and long introduction.
    * Preoperative anesthesia at patients with a hip fracture to a medial third and/or transportation from chamber to the operating room or to the X-ray room, for movement and an arrangement on the operating table, before performance of peridural or subarachnoidal blockade at these patients.
    * After plastics the four-head of a muscle, for an arrangement and removal of plates and screws from a hip or the full prosthetics of a knee joint (FPKJ) at patients who need mobilization in the early postoperative period.
    * These methods improve assessment of acute injury of a knee at an arthroscopy and other operations on a knee joint as blockade of both nerves the sufficient volume of local anesthetic blocks sensitivity of all lower extremity.
    * For a biopsy of muscles at patients with a malignant hyperthermia.

Carrying out technique.
    *  The patient is in situation on spin. The lower extremity is located in easy reduction and outside assignment on 10 ° -20 ° or in "neutral situation". Easy sedation.
    * The operator is located on the opposite side.
    * Anatomic reference points are defined and noted by a marker: the inguinal sheaf stretches from a front upper ileal crest to lateral edge of a pubic hillock; pulsation of a femoral artery.
    * At patients with obesity the assistant has to support "apron" towards the head.
    * The pulsation of a femoral artery is defined, fingers of a hand are located, distributing pressure so that to protect and close an artery below. The femoral artery is the most important reference point.
    * For visualization of a femoral artery it is possible to use a dopplerometriya.