Regional Block Planning Assistant
Generate systematic regional anesthesia block plans with anatomy, ultrasound guidance, and drug d...
What You Can Do
You can systematically design peripheral nerve blocks by organizing anatomical landmarks, ultrasound guidance strategies, local anesthetic dosing calculations, and contingency planning. The skill synthesizes current best practices for ultrasound-guided regional anesthesia (UGRA), incorporates patient-specific contraindications, calculates maximum safe local anesthetic doses accounting for additive effects across multiple blocks, and identifies preventive measures for potential complications.
Features
pinpoints key surface anatomy and sonographic structures for accurate needle positioning
recommends optimal probe positioning and needle trajectory based on block type and patient anatomy
calculates maximum safe doses accounting for patient weight, organ function, and additive effects from multiple medications
flags relevant comorbidities (cardiac, renal, hepatic, pregnancy) affecting block safety and technique selection
structures supplementation strategies and combination blocks to optimize anesthesia quality
describes appropriate gauge, length, in-plane vs. out-of-plane approaches, and advancement strategies
outlines backup blocks and management protocols for failed or inadequate anesthesia
identifies mechanism-based risk mitigation tailored to the specific block and patient factors
Example Output
Example 1: Interscalene Block for Shoulder Surgery
- Patient: 68 kg, HTN, Stage 2 CKD
- Block selection: Ultrasound-guided interscalene, single-shot
- Approach: Linear probe, transverse at C6 level, in-plane technique
- Local anesthetic: 15 mL 0.5% ropivacaine (75 mg) — safe given renal impairment
- Key landmarks: Anterior scalene muscle, middle scalene muscle, C5-C6 nerve roots
- Contingency: Suprascapular + axillary blocks if inadequate anesthesia
Example 2: Femoral + Sciatic Blocks for Knee Surgery
- Patient: 95 kg, diabetic neuropathy, no contraindications
- Combined dosing: Femoral 20 mL 0.5% ropivacaine (100 mg) + Sciatic 20 mL 0.5% ropivacaine (100 mg) = 200 mg total ropivacaine (safe limit 300 mg)
- Femoral approach: Linear probe, inguinal crease, in-plane, needle to lateral femoral nerve
- Sciatic approach: Linear probe, popliteal fossa, in-plane posterior approach
- Risk mitigation: Ultrasound confirmation of needle tip location before injection; slow 5-minute infusion
What's Included
- SKILL.md: complete skill instructions and methodology
- Block Planning Template: structured worksheet capturing patient factors, anatomy, technique selection, dosing, and contingency planning
- Local Anesthetic Dosing Calculator: reference table for maximum safe doses by agent, adjusted for patient weight and organ function
- Ultrasound Approach Guide: descriptions of probe positioning, needle anatomy, and landmark identification for 12+ common blocks
- Comorbidity Screening Checklist: quick reference for contraindications and dose adjustments based on cardiac, renal, hepatic, and pregnancy status
Who It's For
- Regional anesthesiologists — planning elective and emergency peripheral nerve blocks
- Certified Registered Nurse Anesthetists (CRNAs) — designing blocks independently or collaboratively with surgeons
- Anesthesia residents and fellows — developing systematic block planning skills and understanding evidence-based decision-making
- Acute pain management specialists — constructing multimodal regional techniques for perioperative pain control
- Surgeons requesting regional anesthesia — understanding block options and safety considerations for patient-specific cases
Best For
- Planning single-shot and catheter-based peripheral nerve blocks before surgery
- Designing multimodal regional techniques combining multiple blocks or supplementation strategies
- Evaluating block safety and dosing for patients with comorbidities (renal disease, cardiac dysfunction, pregnancy)
- Calculating local anesthetic doses across multiple blocks to avoid toxicity
- Creating contingency plans for failed blocks and training clinical teams on systematic approaches
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