![]() This is because the needle stays in plane and parallel to the linear ultrasound scanner, which is optimal for ultrasound guided injections.” One of the biggest advantages of the lateral approach technique is the excellent visualization of the needle. It’s easy to visualize the where the popliteal artery and femoral condyles at this level, so from here, slight movement of the scanner proximally will identify the target area for injection.” Hickman prefers a lateral approach for this injection, with the patient supine and the leg elevated enough so he can place the ultrasound scanner behind the knee. How to Perform an Ultrasound-Guided IPACK Blockĭr. He believes ultrasound improves the speed of block procedures and also improves the duration of blocks as more medication reaches the target nerve. Hickman has perfected his block techniques over the past 30 years and enjoys sharing what he’s learned during webinars like these and through his popular regional guided anesthesia educational website. Read on for highlights of the IPACK block.ĭr. Greg Hickman, Medical Director and Anesthesia Director at the Andrews Institute Ambulatory Surgery Center in Florida, shared his ultrasound-guided nerve block techniques for more effective regional blocks in patients undergoing knee surgery. ![]() For total knee replacement and ACL surgeries, the goal of the IPACK (Infiltration between the Popliteal Artery and the Compartment of the Knee) block is to block the terminal branches of the obturator and tibial nerves in the posterior knee space, sparing the main trunks of the tibial and common peroneal nerves, thereby maintaining the sensorimotor function of the leg and foot (decreasing foot drop). ![]()
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