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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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PEARLS

An adequate volume of local anesthetic should be used for this block (i.e., 10–15 mL). Because this is a sensory nerve, low concentrations of local anesthetics are useful (i.e., 0.5%–0.75% mepivacaine and lidocaine or 0.25% bupivacaine or 0.2% ropivacaine). By keeping the concentration lower for this portion of a “three- or four-nerve” lower extremity block, adequate volumes and concentrations of local anesthetic can be maintained for the sciatic and femoral nerves. If this block is used to provide anesthesia for a skin graft harvest site on the lateral thigh, the anesthesiologist should remember one thing: In this clinical situation, it is useful to perform the block, wait until sensory changes develop, and then outline the peripheral innervation of the lateral femoral cutaneous nerve in that specific patient before any skin is harvested.

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