Lateral Popliteal Sciatic Block for Supine Patients (CAPS block)
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- čas přidán 29. 08. 2024
- In 2022, I was shown a new and useful technique by Dr Nadia Hernandez (@Nadia_Hdz_MD), which I describe here. I called it the "CALP block", which wasn't a great acronym, but the best I could do. Shortly after posting I was told that this technique has just been described in an excellent free-to-access article, in which it is called the CAPS (Crosswise Approach to Popliteal Sciatic) block. A much better acronym! Apologies and kudos to the authors! Check it out here - www.ncbi.nlm.n...
This video is for informational and educational purposes only. It is not a substitute for professional medical advice, or consultation with a health care professional.
Update - shortly after posting I was told that this technique has just been described in an excellent free-to-access article, in which it is called the CAPS (Crosswise Approach to Popliteal Sciatic) block. A much better acronym! Apologies and kudos to the authors! Check it out here - www.ncbi.nlm.nih.gov/pmc/articles/pmid/35145799/
Could out of plane needle approach be used ?
@@erickim1830 There is no reason you couldn't use an OOP needle approach - as you could for most PNBs. I usually decide this based on block ergonomics, obstacles in the needle path, and the anticipated length of the needle track. The caveats are always your personal comfort with OOP approaches, your ability to triangulate the insertion depth and angle, and thus accurately track the needle tip as well as anticipate the "landing point" on the nerve target.
Is your approach to place block where the two individual nerves begin to separate like a
Traditional popliteal block? Seemed like you placed the block where the nerves were still together as one large sciatic nerve. Thanks.
@@edwardherrera846 I try if I can, to see and target the bifurcation of the sciatic nerve as a general rule. However with this approach, when I have tried it, it so far seems easier to clearly visualize the nerve in the mid-thigh proximal to the bifurcation. I regard target visibility as the priority, as that best guarantees safe and effective needling in my hands. So I remain flexible and adapt to the circumstances which I am presented with.
Thank you for spreading this. Kudos to Dr Hernandes and the authors of the article!
I could have used this the other week instead of having someone to lift the leg and still have to deal with difficult conditions. I definitively see the point of this block in our arsenal.
I will certainly try this technique
I love this approach, been doing it for years!
LAPS block
Lateral approach to popliteal sciatic block sounds better
Very satisfying, look forward to next opportunity to try it
fascinating ! i hope to try it out soon !
I do this technique as a routine for all my blocks
Great video Dr. Chin. But this technique has already been published as ‘CAPS’ block.
Thanks for telling me - I clearly am not up to date with the literature!
How about POPSciCLE block?
POPliteal SCIatic block w CurviLinEar probe
Love the name … but sadly I’ve now been told that it already has an established name - the CAPS block!
Sir it is already described as CAPS block so what is a need of renaming the same block???🥺🥺
Thanks for pointing that out! My bad for not keeping up with the literature!
What does the term crosswise in the CAPS naming means?
Why change what works? A supine popliteal block is easy to perform.
You should always do what works for you. On my part, I find it fun to be curious, and to explore different ways of doing things. And being more versatile is never a bad thing. I have never regretted knowing multiple ways of achieving a particular outcome, even if I have my favorite first-line or go-to technique. At the very least, it has always led to refinements in my thought processes and mental models.
@@KiJinnChin well said
Are patients awake for this?
Yes they generally are. It's well tolerated.