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Friday, April 17, 2026

Pharmacology of Local Anesthetics and Regional Techniques
NCE Board-Style QuestionFree daily question

A 55-year-old male (85 kg, ASA II) undergoes ultrasound-guided femoral nerve block for postoperative analgesia after total knee arthroplasty. During local anesthetic injection, you observe circumferential spread around the femoral nerve on the ultrasound screen. Which injection technique is being described and what is its primary advantage over non-circumferential deposition?

A
Circumferential perineural injection; faster onset by increasing the surface area of nerve exposed to local anesthetic
B
Subfascial injection; longer duration by creating a depot below the fascia iliaca
C
Tangential perineural injection; increased concentration gradient reducing minimum blocking concentration
D
Intraneural injection; direct delivery to nerve fascicles bypassing the perineurial diffusion barrier
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