Nerve Block Techniques Research Articles

Ultrasound-guided obturator nerve block technique at the distal end of the obturator canal: case series and cadaver evaluation

AbstractThe obturator nerve variably gives off the anterior, posterior, and hip articular branches along its course; however, all branches invariably pass through the obturator canal. Herein, we describe our obturator nerve block technique, which promises to deliver local anesthetic directly into the obturator canal. We performed the obturator nerve block in six patients undergoing transurethral resection of bladder tumor under spinal anesthesia. We also evaluated the spread of dye in a cadaver. With patient placed in the lithotomy position, a linear ultrasound transducer was placed on the anterior part of the genitofemoral sulcus, oriented cephalad, to observe the external orifice of the obturator canal, which is present immediately posterior to the posterior end of the inferior margin of the superior pubic ramus and just medial to the body of the ischium. The needle tip was guided to this location, and 10 ml of 1.5% lidocaine was injected into the obturator canal. The procedure was repeated using 10-ml dye in a cadaver. No obturator jerks were observed during the transurethral resection of bladder tumors in all six cases. Cadaver examination confirmed the dye stained the obturator nerve, with retrograde spread into the pelvic cavity via the obturator canal.

Characterization of Gingival Epulis Lesions: A Histological and Morphological Approach

Objective: To conduct a clinical and histopathological study of Epulis at Bhittai medical and Dental College, Mirpurkhas. Methodology: A descriptive cross-sectional study was carried out at the Bhittai medical and Dental College Mirpurkhas. Patients clinically diagnosed with gingival outgrowth, across all age groups and both genders, were included. A provisional diagnosis of epulis was made based on clinical examination. After taking a careful history, relevant clinical features were recorded, and a biopsy procedure was performed using infiltration near the lesion or regional nerve block techniques. The data was documented using a pre-designed proforma and analyzed using SPSS version 22.0. Results: Out of 50 subjects, 30 (60%) were female and 20 (40%) were male. Most cases involved the maxillary gingiva (anterior or posterior) (62%). The majority of lesions measured between 2cm and 3cm (76%). Lesions typically exhibited a soft consistency (70%), with fewer cases being firm (8%) or hard (22%). Histologically, peripheral giant cell granuloma (PG) was most prevalent (50%), followed by fibrous epulis (42%), peripheral ossifying fibroma (4%), and peripheral giant cell granuloma with features of central giant cell granuloma (PGCG) (4%). No cases of congenital epulis or pregnancy tumor were reported. Histological evaluation revealed no significant gender differences (p-value 0.86). Conclusion: Clinically, most epulis lesions presented as painless, soft, coral pink masses, typically measuring approximately 2-3 cm in diameter and exhibiting a sessile form and observed more commonly in females, with a predominant occurrence in the maxillary region. Histopathological examination revealed that the most frequent types were fibrous epulis and peripheral giant cell granuloma.

Comparison of the Analgesic Efficacy of Ultrasound-Guided Transperineal Approach Using Pudendal Nerve Block Versus Caudal Block in Children Undergoing Urological Surgeries: A Randomized Controlled Trial.

Caudal block is an effective regional anesthesia technique for perineal surgeries but is associated with various adverse effects. Recently, pudendal nerve block has emerged as a promising alternative for these procedures. This study assessed the effectiveness of a novel transperineal technique for ultrasound-guided pudendal nerve block and compares it with ultrasound-guided caudal block for perineal surgeries in pediatric patients. The study included 60 American Society of Anesthesiologists (ASA) Physical Status Classification Systemgrade I/II children aged 1-12 years and scheduled for elective perineal operations under general anesthesia. Patients were randomly allocated to two equal groups: Group C (ultrasound-guided caudal block) and Group P (ultrasound-guided pudendal nerve block). The groups were evaluated for time to first rescue analgesia (primary outcome), block performance time, total analgesic consumption, Face, Legs, Activity, Cry, and Consolability (FLACC) scores, time to achieve a Post-Anesthetic Discharge Scoring System (PADSS) score of 9, and any complications. The median interquartile range (IQR) first rescue analgesia time was significantly higher in the pudendal block (17.5 (17-18) hours vs 4.65 (4.5-4.77) hours; p<0.001). The median (IQR) dose of postoperative analgesia (diclofenac) required was similar in the pudendal block group and caudal group (10 (0-10) mg vs 10 (0-20) mg; p=0.290). The median (IQR) FLACC scores at "zero" hour post-surgery were 2 (2-2) and 2 (1-2) in the pudendal and caudal groups, respectively (p=0.052). The median (IQR) PADDS score was significantly higher in the pudendal group (10 (9.25-10) vs 9 (8-9); p<0.001). The time to reach a PADSS score of 9 was significantly longer in the pudendal group (21.4±3 vs 14.9±4.8 hours; p<0.0001). There were no complications in either group. The findings of this study suggest that pudendal nerve blockprovides longer-lasting analgesia, lower pain scores, andfaster readiness for discharge though with a similar analgesic consumption compared to caudal block. These resultsindicate the potential of ultrasound-guided pudendal nerve blocks as a beneficial and safe alternative to caudal block for perineal procedures in children.

Comparison of two ultrasound-guided versus anatomical landmarks techniques for inferior alveolar nerve block in dogs

Comparison of two ultrasound-guided versus anatomical landmarks techniques for inferior alveolar nerve block in dogs

Nerve Blocks for Post-Surgical Pain Management: A Narrative Review of Current Research.

Opioids remain the mainstay of post-surgical pain management; however, concerns regarding addiction and side effects necessitate the exploration of alternatives. This narrative review highlights the potential of nerve blocks as a safe and effective strategy for post-surgical pain control. This review explores the use of various nerve block techniques tailored to specific surgical procedures. These include nerve blocks for abdominal surgeries; fascial plane blocks for chest surgeries; nerve blocks for arm surgeries; and nerve blocks for lower limb surgery including; femoral, hip, and knee surgeries. By targeting specific nerves, these blocks can provide targeted pain relief without the negative side effects associated with opioids. Emerging evidence suggests that nerve blocks can be as effective as opioids in managing pain, while potentially offering additional benefits such as faster recovery, improved patient satisfaction, and reduced reliance on opioids. However, the effectiveness of nerve blocks varies depending on type of surgery, and in individual patients. Rebound pain, which temporary increase in pain after a block wears off, can occur. In addition, some techniques require specialized guidance for accurate placement. In conclusion, nerve blocks show great promise as effective alternatives for managing post-surgical pain. They can reduce the need for opioids and their side effects, leading to better patient outcomes and satisfaction. Future studies should assess the long-term impacts of specific nerve blocks on mortality rates, cost-effectiveness, and their incorporation into multimodal pain management approaches to further enhance post-surgical care.

Ultrasound-guided forearm selective nerve block: A bright future on the horizon

Objective: In light of the advancement of modern medicine, anesthesiologists and surgeons are increasingly prioritizing patient comfort in diagnostic and therapeutic procedures. A growing body of research revolves around the utilization of ultrasound-guided forearm selective nerve blocks for surgeries involving the distal upper limb. This review aims to provide an overview of regional anesthesia techniques in forearm, hand, and wrist surgeries, laying a theoretical foundation for the prospects of ultrasound-guided forearm selective nerve blocks in optimizing comfort during diagnostic and therapeutic procedures. Methods: A retrospective review of literature sourced from the PubMed database was conducted to comprehensively evaluate and elucidate the advantages and drawbacks of ultrasound-guided forearm selective nerve blocks, brachial plexus blocks, Bier blocks, and wrist blocks. Additionally, a summary was provided regarding the selection of local anesthetics for ultrasound-guided forearm selective nerve blocks. Results: Overall, ultrasound-guided forearm selective nerve block techniques exhibit several advantages over Bier’s block, brachial plexus block, and wrist block for the majority of forearm, wrist, and hand surgeries. These advantages include reduced anesthesia-related time, prolonged duration of analgesia, and minimal impairment of upper extremity motor function. Consequently, these techniques enhance surgical safety and facilitate postoperative recovery. Furthermore, the addition of dexmedetomidine or dexamethasone to ultrasound-guided selective nerve blocks of the forearm could extend the duration of analgesia. Conclusion: Ultrasound-guided forearm selective nerve block is a straightforward and conducive anesthesia method for distal upper limb surgeries, aligning with the principles of fast surgical recovery and enhanced patient comfort during diagnostic and therapeutic procedures. Given its manifold benefits, widespread promotion and adoption of this technique in clinical practice are warranted.

Pain and immune function in patients undergoing gastric cancer surgery following stellate ganglion block with total intravenous anesthesia.

Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity. To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer (GC) surgery to provide a reference basis for the formulation of anesthesia protocols for radical GC surgery. This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024. There was no restriction on sex. The patient grouping method used was a digital random table method, and the number of cases in each group was 56. The control group was administered total intravenous anesthesia, and the observation group compounded the stellate ganglion block according to the total intravenous anesthesia protocol. Postoperative hemodynamics, pain levels, and immune indices were compared between the groups. The heart rate and mean arterial pressure in the observation group after intubation were lower than those in the control group (P < 0.05). Pain levels were compared between the two groups at 2 hours, 12 hours, 24 hours, and 48 hours after surgery (P > 0.05). The number of CD3+, CD4+, and CD4+/CD8+ cells at the end of surgery was higher in the observation group than in the control group, and the number of CD8+ cells was lower in the observation group than in the control group (P < 0.05). There were no significant differences between the two groups in terms of propofol dosage, awakening time, extubation time, or postoperative adverse reactions (P > 0.05). The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery. However, it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.

Stellate Ganglion Block may represent an effective therapeutic for Primary Sjögren’s Syndrome

Primary Sjogren’s syndrome (pSS) is a systemic autoimmune inflammatory disease characterized by xerophthalmia and xerostomia,leading to a notable decline in patients’ quality of life. Recent studies have shown a link between the autonomic nervous system (ANS) dysfunction and pSS. The salivary and lacrimal glands are innervated by both sympathetic and parasympathetic nerves, highlighting the role of the ANS. Stellate ganglion block (SGB), a commonly used nerve block technique in clinical settings, exhibits the ability to modulate both the ANS and the immune response. Therefore, our hypothesis suggests that SGB may alleviate xerostomia and xerophthalmia in pSS patients through a short-term mechanism involving the adjustment of ANS balance and vasodilation to facilitate glandular secretion. Additionally, the long-term efficacy of SGB in pSS may be attributed to its neuroimmunomodulatory effects. Furthermore,it is likely that SGB could also improve a variety of ANS-related extra-glandular symptoms in pSS, including digestive, cardiovascular, neurological, and psychological issues.

Comparative Effectiveness of Regional Anesthesia and Nerve Block Techniques in Reducing Chronic Post-Surgical Pain in Adults Undergoing Inguinal Hernia Surgery: A Systematic Review

Background: This study to show about comparative effectiveness of regional anesthesia and nerve block techniques in reducing chronic post-surgical pain in adults undergoing inguinal hernia surgery. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: CPSP is a multifactorial and complex condition that can significantly affect the quality of life of patients undergoing surgery. General anesthesia plus ilioinguinal nerve block is better than spinal anesthesia (SA) regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients. Regional block anesthesia (RBA) is superior to conventional spinal anesthesia (CSA) for pain relief at 24 hours post-surgery.

Understanding the anatomy of pelvic fascia: implications for regional anesthesia.

The fascia, a continuous structure around the whole body across various anatomical locations, remains underexplored in regional anesthesia. The pelvic fascia is a particularly controversial and complicated anatomical structure. It holds significant relevance not only for surgeons but also in the realms of regional anesthesia and pain management. Many regional nerve blocking techniques in the pelvis are closely related to fascial anatomy, such as fascia iliaca compartment block, circum-psoas block, inferior hypogastric plexus block, and ganglion impar block. The continuity of fascia and interfascial spaces profoundly influences both the efficacy of blockades and the incidence of complications. A thorough understanding of pelvic fascia anatomy is crucial for understanding the potential pathways and barriers for spread of local anesthetics, enhancing analgesia, and minimizing side effects. Currently, a systematic discussion of pelvic fascia from the perspective of regional anesthesia and pain therapy is notably absent. This narrative review aims to consolidate knowledge on the anatomy of pelvic fascia pertinent to regional anesthesia and pain management, detailing relevant pelvic nerves, and associated peripheral nerve blocking techniques.

Stellate ganglion block & ventricular arrhythmias.

An electrical or ventricular storm is a life-threatening condition that must be treated as soon as possible. Here we have successfully saved a 32-year-old male patient with ventricular storm by going beyond the conventional treatment of ACLS. The ultrasound-guided stellate ganglion block terminates sympathetic over discharge thus terminates electrical storm. The emergency physicians need to be aware of the right timing, indication & ultrasound-guided nerve block technique as it is time a sensitive & final rescue technique to save the patient. Lack of expertise can lead to treatment failure or delay which can lead to poor resuscitation outcomes.

Intrapulpal anesthesia in endodontics: an updated literature review.

Effective pain management is crucial for the successful performance of various endodontic procedures. Painless treatments are made possible by anesthetizing the tooth to be treated using various nerve-block techniques. However, certain circumstances necessitate supplemental anesthetic techniques to achieve profound anesthesia, especially in situations involving a "hot tooth" in which intrapulpal anesthesia (IPA) is employed. IPA is a technique that involves the injection of an anesthetic solution directly into the pulp tissue and is often utilized as the last resort when all other anesthetic techniques have been unsuccessful in achieving complete pulpal anesthesia. This review focuses on the IPA procedure and the factors that influence its success. Additionally, the advantages, limitations, disadvantages, and future directions of IPA are discussed.

Ultrasound-guided perineural injection of the saphenous nerve in goat cadavers

BackgroundSurgery of the goat stifle joint requires good perioperative analgesia, ideally without affecting motor function in the postoperative period. The objective of this study was to describe an ultrasound-guided technique for saphenous nerve block in goats. Eleven fresh female goat cadavers from two different age groups were used: seven of them were four years old with a mean ± SD body weight of 65.9 ± 7.3 kg. Four animals were six months old and their mean ± SD body weight was 20.1 ± 3.1 kg. The cadavers were positioned in lateral recumbency with the limb to be blocked lowermost. A high-frequency linear transducer (6–12 MHz) was used to localise the interfascial plane between the sartorius and the vastus medialis muscles and to identify the saphenous nerve on the medial aspect of the thigh, caudal to the femur, at the level of the femoral triangle. In 22 pelvic limbs 0.1 mL/kg of methylene blue was injected around the saphenous nerve under ultrasound guidance, followed by gross anatomical dissection. The length of circumferentially stained nerve was measured, and the success rate of achieving at least 1 cm of staining is presented with a 95% confidence interval (CI).ResultsAlthough not all saphenous nerves were sonographically identified, their boundaries were defined as cranial to the femoral artery, lateral to the sartorius muscle, and medial to the vastus medialis and rectus femoris muscles, within the perivascular fat. During anatomical dissection, the overall dye solution distribution was graded as complete in 17/22 limbs indicating a 77.3% success rate [95% CI (0.598, 0.948)], partial in 3/22 limbs and failed in 2/22 limbs.ConclusionsThe success rate of this study indicates the feasibility of employing the ultrasound-guided technique to perform saphenous nerve block in goats. However, further in-vivo studies are recommended to assess the block's clinical efficacy before implementation on clinical patients.

Superficial skin necrosis as a rare complication of inferior alveolar nerve block in Egyptian child: A case report

AbstractAimThe aim of the presented case report was to report a rare complication of Inferior Alveolar Nerve Block (IANB) in a 5‐year‐and‐4‐month‐old child and to discuss the possible complications.Materials and MethodsFive years and four months old Egyptian male child presented in paediatric dentistry practice complaining of pain in the lower right primary molars that kept him awake all night. Examination revealed decayed lower right primary first and second molars and the treatment plan was designed to include a pulpectomy procedure for tooth 85 and a pulpotomy procedure for tooth 84. Administration of 1 mL of arctician 4% with 1:100,000 epinephrine anaesthetic solution using the inferior alveolar nerve block technique was done uneventfully. Then, the dental procedure was done as usual. The next morning, the child presented to the dental practice with a non‐painful change in colour in the lower part of the child's right cheek, with small scanty blisters.ResultsThe possible causes of such a complication and the proper management are discussed in this article with a confirmation of the superficial skin necrosis as the most possible cause.ConclusionAlthough proper awareness of the anatomical structures of the orofacial region along with meticulous administration technique of local anaesthesia is mandatory for the everyday dental practice, the dentist may face possible, sometimes rare complications of local anaesthesia and he should be able to manage them probably.

Radiographic Assessment and Clinical Outcomes of Conservative Management in Atlanto-Axial Osteoarthritis: A Study of 108 Patients

Abstract Background: Atlanto-axial osteoarthritis (AAOA) is a degenerative cervical spine disorder predominantly affecting the elderly. The patients typically present with cervico-occipital pain and restricted and painful neck rotations. The condition is primarily diagnosed with an open-mouth view radiograph, and conservative management is the mainstay of treatment. This study aimed to evaluate the effectiveness of conservative management and a novel technique of greater occipital nerve (GON) block in AAOA and assess the radiographic changes in facet angles and autofusion of the facet joints following conservative management. Materials and Methods: This study was conducted in patients with AAOA. Pre- and post-treatment visual analog scale (VAS) and neck disability index (NDI) scores were compared to evaluate clinical improvement following conservative treatment. Additionally, the radiographs were also assessed for changes in the facet angles observed in AAOA. Data analysis was performed using SPSS version 25.0 (IBM, Chicago, IL, USA). Statistical tests including paired t tests and correlation coefficients were used. Results: The atlanto-axial facet angle was significantly reduced on the affected side (P &lt; 0.001) compared to the unaffected side. GON block significantly improved VAS and NDI scores (P &lt; 0.001). Auto-fusion of the arthritic facet joint was observed in 15.47% of patients following conservative treatment. Conclusion: Conservative management is the mainstay of AAOA treatment, effectively alleviating pain and improving the quality of life in the affected individuals.

Progress of ultrasound-guided nerve block in foot and ankle arthroscopy

Foot and ankle arthroscopy frequently results in severe perioperative swelling and pain. The ultrasound-guided nerve block technique stands out for its ability to offer reliable and potent pain relief. This technique not only promotes early functional exercise, but also realizes enhanced recovery after surgery, which has demonstrated significant advantages in the realm of foot and ankle arthroscopy. In recent years, blocking techniques targeting different nerve planes have been reported to expand the options available for clinical use. This article primarily describes the current application of foot and ankle arthroscopy, detailing various local nerve blocks under innervation and ultrasound guidance. By doing so, this review intends to provide insights for the selection of clinical anesthesia in foot and ankle arthroscopy.

Influence of computerized intraosseous anesthesia compared with traditional mandibular nerve block on children's behavior: A randomized clinical trial.

Effective pain management is crucial for the successful completion of dental procedures in children. Research has examined whether computerized intraosseous anesthesia (CIOA) could serve as a safe and viable substitute for the conventional inferior alveolar nerve block (IANB) technique in pediatric patients. This study investigates the efficacy of CIOA, aiming to determine its effectiveness as an alternative anesthesia method. This study compared the efficacy of local intraosseous anesthesia using a computerized device (QuickSleeper 5) to conventional IANB anesthesia on cooperation and pain perception in children, using a randomized controlled trial design. The study included 88 healthy children, aged between 6 and 9 years, who required pulpotomy for their mandibular second primary molars. The study was approved by the local research ethics committee and registered at clinicaltrials.gov (NCT05193487). The heart rate and Venham behavior rating scale were recorded and analyzed. Categorical data were analyzed using Fisher's exact test. Age and heart rate were compared using an independent t-test for intergroup comparison. The intragroup comparison was carried out using repeated measures ANOVA, followed by the Bonferroni post hoc test. The Mann-Whitney U-test was used to analyze the Venham scale scores. The significance level was set at p < .05 RESULTS: The mean Venham score was slightly higher in the IANB group than in the CIOA group, but was not statistically significant (p = .852). One minute after anesthesia administration, the heart rate (beats per minute [BPM]) was significantly higher in the IANB group (92.30 ± 13.45) than in the CIOA group (83.20 ± 10.40) (p < .001). Additionally, there was a significant difference in heart rate values measured at different intervals within the IANB group. The QuickSleeper 5 device was found to be a feasible alternative for IANB in children over 6 years old.

Three-point Method Nerve Block for Relieving Pain of Microbotox Injection in Middle and Upper Face.

With the popularity of microbotox, pain caused by multiple microdroplets and subcutaneous injection of botulinum toxin is increasing. This study presents a new, refined, three-point nerve block technique that provides effective pain relief during minimally invasive injection therapy targeting the middle and upper face. Fifty volunteers underwent facial ultrasonography to measure the locations of the supraorbital and infraorbital foramen. Following microdrop Botox injection of the middle and upper face, 100 patients underwent a self-controlled study to analyze whether a three-point nerve block surpasses topical anesthesia for reducing injection pain. The visual analog scale pain score, the time of the three-point method and botulinum toxin injection, and side effects were recorded. Among the volunteers, the location of the supraorbital and infraorbital foramen showed no statistical difference between the left and right sides. For the 100 patients (13 men, 87 women) who underwent the three-point nerve block, the visual analog scale pain scores on the experimental side were significantly lower than those on the control side, except in the frontotemporal region (2.46 ± 0.50, 2.42 ± 0.47, P > 0.05). The duration of the unilateral three-point nerve block was 74.8 ± 5.64 seconds. The total injection time was 189.86 ± 26.79 seconds (range 148-286 s). The three-point method exerted prominent analgesic effects during middle and upper facial treatments, with benefits including a precise block region, high satisfaction, and simple operation technique. Therefore, clinicians can easily master and apply this method.

Comparison of Analgesic Effects of Continuous Femoral Nerve Block, Femoral Triangle Block, and Adductor Block After Total Knee Arthroplasty: A Randomized Clinical Trial.

This study aimed to compare the analgesic effects of continuous femoral nerve block (FNB), femoral triangle block (FTB), and adductor canal block (ACB) following total knee arthroplasty (TKA). The goal was to identify the most effective nerve block technique among these. Patients undergoing TKA were randomly assigned to 1 of 3 groups: FNB, FTB, or ACB. Nerve blocks were administered preoperatively, with catheters placed for patient-controlled nerve analgesia (PCNA). The primary end point was the Numeric Rating Scale (NRS) score at movement at 24 hours postsurgery. Secondary end points included NRS scores at rest and movement, quadriceps strength, Timed Up and Go (TUG) test performance, range of motion, effective PCNA utilization, and opioid consumption at various postsurgery time points. Of the 94 valid data sets analyzed (FNB: 31, FTB: 31, ACB: 32), significant differences were observed in the primary end point (H=7.003, P =0.03). Post hoc analysis with Bonferroni correction showed that the FNB group had a significantly lower median pain score (3 [2 to 4]) compared with the ACB group (4 [3 to 5], Bonferroni-adjusted P =0.03). Regarding secondary end points, both the FNB and FTB groups had significantly lower NRS scores than the ACB group at various time points after surgery. Quadriceps strength and TUG completion were better in the FTB and ACB groups. There were no statistically significant differences among the groups for the other end points. Continuous FTB provides postoperative analgesia comparable to FNB but with the advantage of significantly less impact on quadriceps muscle strength, a benefit not seen with FNB. Both FTB and ACB are effective in preserving quadriceps strength postoperatively.

The Gluteus Deep Investing Fascia Compartment Block: A Novel Technique for Posterior Femoral Cutaneous Nerve Block.

The posterior femoral cutaneous nerve (PFCN) block is used in regional anesthesia for lower extremity surgery. This study introduces a new ultrasound-guided technique called the "Gluteus-Deep Investing Fascia compartment Block (GDIF block)"for blocking the PFCN. This approach involves injecting local anesthetic into the potential space between the gluteus maximus muscle and the deep investing fascia, named the 'Gluteus Deep Investing Fascia Compartment'. The study discusses the anatomical and sonographic features crucial for identifying this compartment and explores the potential benefits of this approach for achieving effective PFCN block. Additionally, it examines the clinical application of the GDIF block for PFCN block as part of the Complete Lower Extremity Fascia Tri-compartment Block technique, named"CLEFT Block." This technique combines the suprainguinal fascia iliaca block with GDIF compartment block for PFCN and a sciatic nerve block as exclusive anesthesia technique. Nine patients with weapon-related lower limb injuries underwent surgery at district hospitals supported by the International Committee of the Red Cross. Between October and December 2023, seventeen above-knee procedures were performed for the nine patients using the GDIF block as part of a CLEFT block technique. Anesthesia was performed with a CLEFT block technique using a volume ratio of 1:1 of 1% lidocaine and 0.5% levobupivacaine. The GDIF block technique for PFCN blockade was performed successfully in all patients without complications, achieving complete PFCN blockade. The CLEFT block technique proved effective as the sole anesthetic technique for seventeen above-knee procedures. All surgeries were completed successfully without additional pain medication or conversion to general anesthesia. The GDIF block appears to be a promising technique for anesthetic management, alone or as part of the CLEFT block. Further research with a larger patient population is necessary to validate these findings.