2 questions 1) Must you visualise the lifting of the DCIA? 2) Is the fascia iliaca always directly below the DCIA - hence forth would positioning the needle just below the DCIA be another appropriate method?
I consider the DCIA more of a structure to be avoided rather than a surrogate endpoint target. It also usually sits superficial to transversus abdominis, so it's separated from fascia iliaca by this muscle. As such, I don't expect to see lifting of the artery, nor am I looking for it. I just want to avoid it as I insert the needle, and then I want to see spread under fascia iliaca pushing the muscle down. Hope that helps!
if you want the flexibility to extend the block. You can run infusion or give int boluses as you wish. Quad weakness depends somewhat on LA conc - more dilute, less so. There can be a sweet spot for analgesia and mobility, but hard to give a one size fits all recipe in medicine.
2 questions
1) Must you visualise the lifting of the DCIA?
2) Is the fascia iliaca always directly below the DCIA - hence forth would positioning the needle just below the DCIA be another appropriate method?
I consider the DCIA more of a structure to be avoided rather than a surrogate endpoint target. It also usually sits superficial to transversus abdominis, so it's separated from fascia iliaca by this muscle. As such, I don't expect to see lifting of the artery, nor am I looking for it. I just want to avoid it as I insert the needle, and then I want to see spread under fascia iliaca pushing the muscle down. Hope that helps!
What is the indication for catheter , do you give intermittent blouses? Any problem with mobilization ?
if you want the flexibility to extend the block. You can run infusion or give int boluses as you wish. Quad weakness depends somewhat on LA conc - more dilute, less so. There can be a sweet spot for analgesia and mobility, but hard to give a one size fits all recipe in medicine.