Ultrasound guided 4 in 1 block - a newer, single injection technique for complete postoperative analgesia for knee and below knee surgeries

ABSTRACT

Introduction: The demand for better outcome with increased incidence of lower limb surgeries have increased interest in advanced techniques which, reduce complications and lower perioperative morbidity and mortality. The regional analgesia techniques, which provide better outcome, for knee and below knee surgeries provide excellent options for perioperative care for every age group of patients. The combination of the femoral nerve block with sciatic nerve block has provided adequate analgesia with lower consumption of perioperative opioids and rescue analgesia, for knee and below knee surgeries. We describe a novel and single injection technique for the combined 4-in-1 block [saphenous nerve, obturator nerve, nerve to vastus medialis and sciatic nerve] with a single injection point