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Patient Positioning

 

Augmented Positioning Guide: This section goes beyond simple patient positioning. It demonstrates the ideal placement of the ultrasound probe and the correct needle direction, ensuring optimal technique for regional anaesthesia.


Optimal Patient Positioning: Ensure better access to target nerves, improving procedural efficiency in regional anaesthesia.


Enhanced Ultrasound Imaging: Correct positioning maximises anatomical visibility, enabling clearer ultrasound guidance for precision nerve blocks.


Reduced Patient Discomfort: Proper patient positioning minimises discomfort, enhancing the overall experience during regional anaesthesia procedures.


Increase Procedure Success: Master positioning techniques to boost success rates and ensure safer, more effective outcomes in regional anaesthesia.

 

Intermediate Cervical Plexus Block


ARIRA regional anaesthesia course, supine position shown for cervical plexus block
Cervical Plexus Block - Supine position
ARIRA regional anaesthesia course, lateral position shown for cervical plexus block
Cervical Plexus Block - Lateral position

Semi-recumbent with the head turned slightly to the opposite side of the block.

Lateral positioning can be considered depending on patient comfort and specific clinical requirements.

Pillow Support: Place a small pillow under the patient's head and upper back on the side opposite the block. This elevation creates additional space, making it easier to access the neck for needle insertion.


Rationale

Stability: The positioning ensures a stable and secure setup, minimising patient movement during the procedure, which is crucial for accuracy and safety.

Access: Enhances access to the neck by allowing easier identification of landmarks, such as the transverse processes of the cervical vertebrae, and facilitating accurate needle placement. The additional pillow support creates more space for the anaesthetist's hand and needle.

Safety: Maintains airway patency, reducing the risk of complications like airway obstruction or aspiration, particularly in sedated patients.

Exposure: Improves the visibility of the sternocleidomastoid muscle by gently stretching it, making anatomical landmarks more distinct and accessible.

Vascular Protection: Positions the carotid artery and jugular vein further from the injection site, decreasing the risk of accidental vascular puncture.

Comfort: Promotes patient comfort by keeping the airway open and ensuring easy, unobstructed breathing throughout the procedure.

Ergonomics: Optimises the anaesthetist's working posture, reducing the need for awkward bending or twisting, minimising fatigue, and enabling more precise technique. The pillow support also provides better arm positioning for the anaesthetist.


Special Considerations

Obese Patients: May require additional pillows, supports, or positioning adjustments to ensure proper neck extension and adequate access to the target area. The use of pillows can also help elevate the head and neck, providing more space for needle manipulation.

Patients with Neck Injuries: Careful positioning to avoid over-rotation or hyperextension of the neck is crucial to prevent exacerbation of injuries or discomfort.

Anxiety or Claustrophobia: These patients may benefit from additional comfort measures, such as mild sedation or providing reassurance. Proper pillow placement and positioning can also help make the patient feel more secure, reducing anxiety.

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