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ISRN Anesthesiology
Volume 2011 (2011), Article ID 421505, 10 pages
http://dx.doi.org/10.5402/2011/421505
Review Article

The Loss of Resistance Nerve Blocks

1Department of Anaesthesia, Royal Liverpool University Hospitals, 11th Floor Prescot street, Liverpool L7 8XP, UK
2Mersey Deanery, Summers Road, Liverpool L3 4BL, UK

Received 10 August 2011; Accepted 15 September 2011

Academic Editor: A. Mizutani

Copyright © 2011 Shiv Kumar Singh and S. M. Gulyam Kuruba. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Presently ultrasound guided nerve blocks are very fashionable but vast majority of people around the world cannot practice these techniques mostly due to lack of resources but even in the developed countries there is lack of training which precludes people from using it. Lack of resources does not mean that patient cannot be provided with appropriate pain relief using nerve blocks. There are some nerve blocks that can be done using the loss of resistance (LOR) techniques. These blocks like, tranversus abdominis plane (TAP), rectus sheath, ilio-inguinal and fascia iliaca blocks can be effectively utilized to provide pain relief in the peri-operative period. For these blocks to be effectively delivered it is essential to understand the anatomical basis. It is also important to understand the reasons for failure, which is mostly due to delivery of the local anaesthetic in the wrong plane. The technique for LOR is not only simple and effective but also it can be delivered with minimal resources. This article deals with the techniques used for LOR blocks, the relevant anatomy and the methods used to administer the blocks. The article also describes the various indications where these blocks can be utilized, especially in the post-operative period where the pain management is sub-optimal.