Lower limb regional anaesthesia: plexus and peripheral blocks

Model answer

Framing. Lower-limb blocks are chosen by territory: femoral/fascia iliaca for anterior thigh and hip fracture analgesia, adductor canal for motor-sparing knee analgesia, sciatic (popliteal) for posterior leg and foot, IPACK for posterior knee capsule; combine thoughtfully, prefer ultrasound, respect compartment-syndrome surveillance, and keep LAST lipid rescue available.^[1]

Must cover.

• Lumbosacral plexus relevant anatomy (taught)
• Femoral and fascia iliaca for hip fracture (taught pathway)
• Adductor canal motor-sparing rationale — equivalent analgesia with faster mobilisation than femoral block^[3]
• Sciatic approaches including popliteal (taught)
• IPACK and knee arthroplasty multimodal plan (taught)
• Compartment syndrome and dense block debate — thin published record, breakthrough pain as the alarm^[2]
• LAST and dose calculation across combined blocks^[1]
• Comparison with neuraxial for lower limb surgery (taught)

Crisis. Missed compartment syndrome after dense lower-limb block^[2]

High-yield numbers/facts. Include exact taught figures where relevant (lipid emulsion dosing per the local protocol for LAST; block-specific local-anaesthetic maxima per protocol).^[1]