US and CT guided Peripheral Nerve Blocks
Ali Reza Moghtaderi,M.D.
Physical Medicine and Rehabilitation
Fellowship of Interventional Pain
****Greater and Lesser Occipital Nerve Block
Technique:- The most effective patient position for the greater or lesser occipital block is sitting with the neck in a flex position’Avoid foramen magnum which is located medially’The occipital artery is the most useful landmark for locating the GON, immediately medial to oc.A
****SUPERIOR HYPOGASTRIC BLOCK
Technique:The patient will be in prone position.’Needle is introduced 6 cm lateral to spine of L4.’ Directed 45 degrees medial and caudal until its tip comes anterior to vertebral body of L5 under fluoroscopic guidance.
****GANGLION IMPAR BLOCK
Technique:The patient in the prone position.’Needle is inserted in the dorsal sacrococcygeal ligament at the midline.’ The needle is then advanced to pierce the ventral sacrococcygeal ligament, felt as a loss of resistance.
****CELIAC PLEXUS BLOCK:
Classic retrocrural technique (deep splanchnic approach): Triangle is made between 3 points: spine between T 12 & L 1 and lower edges of 12th rib on both sides.’ Needle is inserted just cauded to 12th rib 7 cm lateral to midline, 45 degree from horizontal plane & 15 degree cephaled until bony contact with L1 vertebral body is made.’ Needle is withdrawn & redirected laterally about 1-2 cm, at this point aortic pulsations may be felt and the local anesthetic is injected retroaortic.
آدرس مطب : اصفهان خیابان شمس آبادی چهارراه قصر ساختمان قصر نور واحد 305
تلفن : 32240068 - 031