Top Tweets for #ABFNBlock
"PENG Block"
Do u know about other Pericapsular Blocks of Hip joint?
#PENGblock
#Pericapsularblocks
#Hipjointanalgesia
#RAinHipSx
#IPPBlock #IlioPsoasPlaneBlock
#ABFNBlock
My 10 Points:
1. A PENG block involves a pericapsular plexus consisting of articular branches (arising from FN, OBN, and accessory OBN) that supply the anterior hip joint capsule. However, two infrainguinal blocks [Iliopsoas plane block (IPP) and Articular Branch of FN (ABFN) block] also cover capsular innervation.
Total 3 Pericapsular blocks: 1 suprainguinal (PENG) and 2 infrainguinal (IPP and ABFN).
2. An IPP block with 5-10 ml can have the same coverage as PENG. ABFN block with 20 ml involves articular branches of FN only (not OBN/AOBN).
3. A PENG block with LA volume of up to 20 ml is required to involve all articular branches. However, lower volumes (10-15ml) can have a patchy effect due to inadequate coverage.
4. A PENG block with higher volumes (30-40 mL) is also described to provide analgesia to the acetabulum #, subtrochanteric #, or femoral shaft #. Higher volumes may involve articular and parent branches (FN and OBN).
5. The target site in the PENG block is the iliopubic eminence (IPE), where the Psoas Minor tendon gets inserted. It appears as a hyperechoic round structure over IPE that gets elevated during LA deposition. The Psoas Major tendon gets inserted over the lesser trochanter of the femur. Both Psoas muscles lie medial to the iliacus muscle within the fascia iliaca.
6.PENG block region can be divided into 3 Zones: WHITE (below Psoas tendon), BLACK (near the femoral nerve and vessels), and GRAY (below the black zone and above the Psoas tendon). The ideal injection site is below the Psoas tendon, i.e., the WHITE zone. BLACK zone injection can be associated with Quadriceps weakness due to FN involvement. GRAY zone injections are common in obese and difficult anatomy patients, leading to mixed effects depending on LA Concentration and Volume.
7. Quadriceps weakness is mainly due to the involvement of FN either due to LA volume (>20 ml), LA concentration (Higher>Lower), or proximity (BLACK zone).
8. The analgesic effect of PENG block is mainly due to the blockade of all innervations of the anterior capsule of the Hip joint. Some suspect possible joint analgesia due to LA deposition in the iliopectineal bursa beneath the psoas tendon, which communicates with the hip joint. However, this bursa lies mainly over the anterior capsule and has no connection to the joint cavity.
9. Possible (SPECULATED )complications of PENG block Include - Laterally, injury to LFCN at the needle entry point while directing the needle towards the target site. Medially, the needle can enter the ureter, especially when the bladder is full (pushing the ureter close to the target site). At the target site, iliopectineal bursitis can develop due to direct needle injury.
10. PENG provides optimum and faster onset analgesia (resting and dynamic) when used as an “on-arrival” block due to complete coverage of the richly innervated and more nociceptive anterior capsule. PENG + LFCN = Perioperative analgesia option.
For other details, Plz Click on,
https://t.co/gmSnN9tOYE
https://t.co/wrOAhHBhri
https://t.co/umqGWp7KHt
If you know any of the interesting points about PENG block, Plz Share.
![KartikBSonawane's tweet photo. "PENG Block"
Do u know about other Pericapsular Blocks of Hip joint?
#PENGblock
#Pericapsularblocks
#Hipjointanalgesia
#RAinHipSx
#IPPBlock #IlioPsoasPlaneBlock
#ABFNBlock
My 10 Points:
1. A PENG block involves a pericapsular plexus consisting of articular branches (arising from FN, OBN, and accessory OBN) that supply the anterior hip joint capsule. However, two infrainguinal blocks [Iliopsoas plane block (IPP) and Articular Branch of FN (ABFN) block] also cover capsular innervation.
Total 3 Pericapsular blocks: 1 suprainguinal (PENG) and 2 infrainguinal (IPP and ABFN).
2. An IPP block with 5-10 ml can have the same coverage as PENG. ABFN block with 20 ml involves articular branches of FN only (not OBN/AOBN).
3. A PENG block with LA volume of up to 20 ml is required to involve all articular branches. However, lower volumes (10-15ml) can have a patchy effect due to inadequate coverage.
4. A PENG block with higher volumes (30-40 mL) is also described to provide analgesia to the acetabulum #, subtrochanteric #, or femoral shaft #. Higher volumes may involve articular and parent branches (FN and OBN).
5. The target site in the PENG block is the iliopubic eminence (IPE), where the Psoas Minor tendon gets inserted. It appears as a hyperechoic round structure over IPE that gets elevated during LA deposition. The Psoas Major tendon gets inserted over the lesser trochanter of the femur. Both Psoas muscles lie medial to the iliacus muscle within the fascia iliaca.
6.PENG block region can be divided into 3 Zones: WHITE (below Psoas tendon), BLACK (near the femoral nerve and vessels), and GRAY (below the black zone and above the Psoas tendon). The ideal injection site is below the Psoas tendon, i.e., the WHITE zone. BLACK zone injection can be associated with Quadriceps weakness due to FN involvement. GRAY zone injections are common in obese and difficult anatomy patients, leading to mixed effects depending on LA Concentration and Volume.
7. Quadriceps weakness is mainly due to the involvement of FN either due to LA volume (>20 ml), LA concentration (Higher>Lower), or proximity (BLACK zone).
8. The analgesic effect of PENG block is mainly due to the blockade of all innervations of the anterior capsule of the Hip joint. Some suspect possible joint analgesia due to LA deposition in the iliopectineal bursa beneath the psoas tendon, which communicates with the hip joint. However, this bursa lies mainly over the anterior capsule and has no connection to the joint cavity.
9. Possible (SPECULATED )complications of PENG block Include - Laterally, injury to LFCN at the needle entry point while directing the needle towards the target site. Medially, the needle can enter the ureter, especially when the bladder is full (pushing the ureter close to the target site). At the target site, iliopectineal bursitis can develop due to direct needle injury.
10. PENG provides optimum and faster onset analgesia (resting and dynamic) when used as an “on-arrival” block due to complete coverage of the richly innervated and more nociceptive anterior capsule. PENG + LFCN = Perioperative analgesia option.
For other details, Plz Click on,
https://t.co/gmSnN9tOYE
https://t.co/wrOAhHBhri
https://t.co/umqGWp7KHt
If you know any of the interesting points about PENG block, Plz Share.](https://pbs.twimg.com/media/F-0w3NdXEAAVXiB.jpg)
![KartikBSonawane's tweet photo. "PENG Block"
Do u know about other Pericapsular Blocks of Hip joint?
#PENGblock
#Pericapsularblocks
#Hipjointanalgesia
#RAinHipSx
#IPPBlock #IlioPsoasPlaneBlock
#ABFNBlock
My 10 Points:
1. A PENG block involves a pericapsular plexus consisting of articular branches (arising from FN, OBN, and accessory OBN) that supply the anterior hip joint capsule. However, two infrainguinal blocks [Iliopsoas plane block (IPP) and Articular Branch of FN (ABFN) block] also cover capsular innervation.
Total 3 Pericapsular blocks: 1 suprainguinal (PENG) and 2 infrainguinal (IPP and ABFN).
2. An IPP block with 5-10 ml can have the same coverage as PENG. ABFN block with 20 ml involves articular branches of FN only (not OBN/AOBN).
3. A PENG block with LA volume of up to 20 ml is required to involve all articular branches. However, lower volumes (10-15ml) can have a patchy effect due to inadequate coverage.
4. A PENG block with higher volumes (30-40 mL) is also described to provide analgesia to the acetabulum #, subtrochanteric #, or femoral shaft #. Higher volumes may involve articular and parent branches (FN and OBN).
5. The target site in the PENG block is the iliopubic eminence (IPE), where the Psoas Minor tendon gets inserted. It appears as a hyperechoic round structure over IPE that gets elevated during LA deposition. The Psoas Major tendon gets inserted over the lesser trochanter of the femur. Both Psoas muscles lie medial to the iliacus muscle within the fascia iliaca.
6.PENG block region can be divided into 3 Zones: WHITE (below Psoas tendon), BLACK (near the femoral nerve and vessels), and GRAY (below the black zone and above the Psoas tendon). The ideal injection site is below the Psoas tendon, i.e., the WHITE zone. BLACK zone injection can be associated with Quadriceps weakness due to FN involvement. GRAY zone injections are common in obese and difficult anatomy patients, leading to mixed effects depending on LA Concentration and Volume.
7. Quadriceps weakness is mainly due to the involvement of FN either due to LA volume (>20 ml), LA concentration (Higher>Lower), or proximity (BLACK zone).
8. The analgesic effect of PENG block is mainly due to the blockade of all innervations of the anterior capsule of the Hip joint. Some suspect possible joint analgesia due to LA deposition in the iliopectineal bursa beneath the psoas tendon, which communicates with the hip joint. However, this bursa lies mainly over the anterior capsule and has no connection to the joint cavity.
9. Possible (SPECULATED )complications of PENG block Include - Laterally, injury to LFCN at the needle entry point while directing the needle towards the target site. Medially, the needle can enter the ureter, especially when the bladder is full (pushing the ureter close to the target site). At the target site, iliopectineal bursitis can develop due to direct needle injury.
10. PENG provides optimum and faster onset analgesia (resting and dynamic) when used as an “on-arrival” block due to complete coverage of the richly innervated and more nociceptive anterior capsule. PENG + LFCN = Perioperative analgesia option.
For other details, Plz Click on,
https://t.co/gmSnN9tOYE
https://t.co/wrOAhHBhri
https://t.co/umqGWp7KHt
If you know any of the interesting points about PENG block, Plz Share.](https://pbs.twimg.com/media/F-0w16SWQAA6qbZ.jpg)
![KartikBSonawane's tweet photo. "PENG Block"
Do u know about other Pericapsular Blocks of Hip joint?
#PENGblock
#Pericapsularblocks
#Hipjointanalgesia
#RAinHipSx
#IPPBlock #IlioPsoasPlaneBlock
#ABFNBlock
My 10 Points:
1. A PENG block involves a pericapsular plexus consisting of articular branches (arising from FN, OBN, and accessory OBN) that supply the anterior hip joint capsule. However, two infrainguinal blocks [Iliopsoas plane block (IPP) and Articular Branch of FN (ABFN) block] also cover capsular innervation.
Total 3 Pericapsular blocks: 1 suprainguinal (PENG) and 2 infrainguinal (IPP and ABFN).
2. An IPP block with 5-10 ml can have the same coverage as PENG. ABFN block with 20 ml involves articular branches of FN only (not OBN/AOBN).
3. A PENG block with LA volume of up to 20 ml is required to involve all articular branches. However, lower volumes (10-15ml) can have a patchy effect due to inadequate coverage.
4. A PENG block with higher volumes (30-40 mL) is also described to provide analgesia to the acetabulum #, subtrochanteric #, or femoral shaft #. Higher volumes may involve articular and parent branches (FN and OBN).
5. The target site in the PENG block is the iliopubic eminence (IPE), where the Psoas Minor tendon gets inserted. It appears as a hyperechoic round structure over IPE that gets elevated during LA deposition. The Psoas Major tendon gets inserted over the lesser trochanter of the femur. Both Psoas muscles lie medial to the iliacus muscle within the fascia iliaca.
6.PENG block region can be divided into 3 Zones: WHITE (below Psoas tendon), BLACK (near the femoral nerve and vessels), and GRAY (below the black zone and above the Psoas tendon). The ideal injection site is below the Psoas tendon, i.e., the WHITE zone. BLACK zone injection can be associated with Quadriceps weakness due to FN involvement. GRAY zone injections are common in obese and difficult anatomy patients, leading to mixed effects depending on LA Concentration and Volume.
7. Quadriceps weakness is mainly due to the involvement of FN either due to LA volume (>20 ml), LA concentration (Higher>Lower), or proximity (BLACK zone).
8. The analgesic effect of PENG block is mainly due to the blockade of all innervations of the anterior capsule of the Hip joint. Some suspect possible joint analgesia due to LA deposition in the iliopectineal bursa beneath the psoas tendon, which communicates with the hip joint. However, this bursa lies mainly over the anterior capsule and has no connection to the joint cavity.
9. Possible (SPECULATED )complications of PENG block Include - Laterally, injury to LFCN at the needle entry point while directing the needle towards the target site. Medially, the needle can enter the ureter, especially when the bladder is full (pushing the ureter close to the target site). At the target site, iliopectineal bursitis can develop due to direct needle injury.
10. PENG provides optimum and faster onset analgesia (resting and dynamic) when used as an “on-arrival” block due to complete coverage of the richly innervated and more nociceptive anterior capsule. PENG + LFCN = Perioperative analgesia option.
For other details, Plz Click on,
https://t.co/gmSnN9tOYE
https://t.co/wrOAhHBhri
https://t.co/umqGWp7KHt
If you know any of the interesting points about PENG block, Plz Share.](https://pbs.twimg.com/media/F-0w0prXIAAcDkD.jpg)
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