Regional Anesthesia Case Planning & Block Selection Assistant
Plan regional anesthesia blocks with evidence-based case assessment and technique optimization
What You Can Do
Systematically assess patient anatomy, comorbidities, and surgical requirements to select optimal regional anesthesia techniques. The skill generates structured pre-operative evaluations, block selection rationales, contingency plans, and informed consent documentation—reducing cognitive load during complex case planning while maintaining your clinical authority over all decisions.
Features
evaluates comorbidities, anticoagulation status, anatomy, and contraindications relevant to block selection
recommends single-shot, continuous, or combination blocks for complex surgical sites requiring multi-compartment coverage
references landmark and ultrasound-guided approaches tailored to patient body habitus and imaging challenges
identifies patient-specific risk factors (neuropathy, renal disease, obesity, anticoagulation) and mitigation strategies
develops backup block plans and general anesthesia bridges for incomplete blocks or failed techniques
structures patient education points and risk discussion for specific block selections
organizes clinical reasoning in formats suitable for junior provider education and surgeon collaboration
Example Output
Case: 68-year-old on warfarin for atrial fibrillation undergoing total knee arthroplasty
Recommended Approach: Femoral nerve block + sciatic nerve block (both single-shot) with neuraxial adjuncts avoided due to anticoagulation. Ultrasound-guided techniques preferred over landmark given body habitus and reduced bleeding risk.
Contingency: If incomplete sciatic block → supplement with intravenous analgesia + surgical local infiltration; if complete failure → consider spinal anesthesia after INR reversal (24-48 hrs) or general anesthesia with regional rescue.
Risk Mitigation: Verify INR <2.5 pre-operatively; use minimal needle passes; avoid perineural injection pressure monitoring; document coagulation status in record.
Case: 35-year-old with type 2 diabetes and BMI 38 undergoing rotator cuff repair
Recommended Approach: Interscalene block (ultrasound-guided, 3-point visualization) with preoperative ultrasound assessment of cervical nerve root visibility. Continuous catheter placement for 48-hour analgesia given obesity-related difficulty with supplemental anesthesia.
Contingency: If block fails or inadequate → general anesthesia with regional rescue; single-shot re-attempt acceptable if first attempt high-confidence.
Special Considerations: Assess for subclinical neuropathy via sensory exam; monitor for horseradish syndrome (phrenic nerve block); ensure post-operative pain catheter management plan documented.
What's Included
- SKILL.md instruction file: complete framework for regional anesthesia case assessment
- Pre-operative Assessment Template: structured checklist for patient evaluation, comorbidity screening, and contraindication identification
- Block Selection Flowchart: decision tree for single vs. multi-modal block approaches based on surgical site and patient factors
- Contingency Planning Worksheet: backup techniques, failure thresholds, and general anesthesia bridges
- Informed Consent Outline: patient education points, risk disclosure, and success rate communication framework
Who It's For
- CRNAs managing complex regional anesthesia cases with comorbidities or anatomic challenges
- Anesthesiologists planning multi-modal or multi-compartment blocks for high-risk patients
- Regional anesthesia educators and residency/fellowship faculty supervising block training
- Perioperative clinicians preparing informed consent discussions and pre-operative documentation
- Anesthesia teams collaborating with surgeons on block selection for unfamiliar procedures
Best For
- Pre-operative planning for patients with significant comorbidities (anticoagulation, renal disease, neuropathy, obesity)
- Complex surgical cases requiring multi-level or multi-modal block combinations
- Novel or unfamiliar surgical procedures requiring block anatomy review and technique selection
- Contingency planning and failure scenario documentation for high-stakes cases
- Teaching and junior provider mentorship on evidence-based block selection reasoning
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