• Reg Anesth Pain Med · Nov 2002

    Assessment of lower extremity nerve block: reprise of the Four P's acronym.

    • Joseph M Neal.
    • Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington.
    • Reg Anesth Pain Med. 2002 Nov 1; 27 (6): 618-20.

    Background And ObjectivesSuccessful performance of lower-extremity regional anesthesia includes sensory and/or motor block assessment of up to 4 major peripheral nerves. This brief report describes a methodology for the rapid evaluation of lower-extremity anesthesia before surgical incision.MethodsIllustrations highlight the techniques for evaluation of sciatic, obturator, lateral femoral cutaneous, and femoral nerve anesthesia. This methodology is based on a Four P's acronym: push, pull, pinch, punt.ConclusionsAccurate assessment of lower-extremity regional anesthesia can be achieved rapidly using The Four Ps evaluation tool.

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