Femoral triangle vs. adductor? iPACK vs. surgical infiltration? Wait...geniculars, what?! In this episode, Amit & Jeff discuss ALL the ways to keep total knee patients comfortable while reducing side effects and getting these patients moving and out the door. Listen in to hear the anatomic basis for why we do these blocks and some tips and tricks for making them work for you.
Version: 20240731
Comments (10)
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You are definitely not alone!!
Wednesday Oct 23, 2024
Fascinating insight. Thanks for sharing
Wednesday Oct 23, 2024
Thanks for this
Wednesday Oct 23, 2024
Again - incredible to hear this!
Wednesday Oct 23, 2024
Thanks for your comments. It is fascinating to hear about RA practice worldwide
Wednesday Oct 23, 2024
About IT morphine: the nursing education officer really did not want to teach her floor nurses about handling patients with long acting spinal morphine on board. So…. we only do it on OB. Also, the Orthopods order oral oxy for their patients pre-op, and IT morphine would just be too too much with that….and they are getting pretty woozy with preop gabapentin on board as well….
Saturday Jan 07, 2023
And a comment about POUR after joint replacement: GETA poses a risk when glyco is used for reversal. Apparently the Ortho literature has discovered this risk from anticholinergics and now our Dr Bone Bros all request Sugammadex for reversal 🥸
Saturday Jan 07, 2023
….and also by standing up, so that my hips were not flexed. If your patients were either supine or ambulatory, that probably mitigated any TRI symptoms 👍
Saturday Jan 07, 2023
About TRI after lidocaine spinals: I was one of the study subjects who got TRI in a study at Virginia Mason, where is did my fellowship, in the late 90’s. The important contribution factor was sacral stretch by hip flexion. So if your TKA patients in your study did not develop TRI, it may well be that having one leg flexed only part of the time wasn’t enough to irritate the nerve roots? Also, the ache I felt from the TRI was relieved by anti-inflammatory Toradol (NSAID is a component of MMA)
Saturday Jan 07, 2023
Thank you for this talk session! I’m grateful to learn that I’m not the only one who is challenged by TAP blocks, even though the target plane is RIGHT THERE!
Saturday Jan 07, 2023
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