KEY POINTS

1. In performing peripheral nerve blocks, elicitation of a paresthesia is equivalent to electrical stimulation. Success rate and onset time are further improved if multiple stimulations are performed.
2. Elicitation of a paresthesia or motor response to the arm and shoulder are equally efficacious when performing an interscalene block.
3. Diaphragmatic paresis occurs in 100% of patients undergoing interscalene block, even with dilute local anesthetic solutions.
4. Continuous femoral nerve block improves outcome and rehabilitation after total-knee replacement and is superior to epidural analgesia.
5. The sciatic nerve divides into its tibial and peroneal components 7 to 10 cm above the knee, and a popliteal fossa block should be performed at this level.
6. Total local anesthetic dosage should be determined and kept within acceptable limits. Accumulation with time may occur with continuous techniques.
7. The frequency of neurologic complications after peripheral blockade is less than that associated with neuraxial techniques. Neurotoxicity and direct needle trauma are the major causes of neurologic complications.