Dude, forget the high dose of local this patient got.
You can barely even fit 20ml into the adductor canal in normal patients. Where is the extra 10 going?
Have you seen the papers on the ED95s for volume for effective interscalenes and supraclavs (for postop pain)? We're talking about the range of like 10-15ml for a super long, super dense block.
For interscalenes, supraclavs, infraclavs, adductors, if there's great spread with 15ml or so, maybe 20, I'm done.
Popliteals I like a bit more because of the big surface area of the nerve and the slow onset. But that's probably voodoo too.
In my opinion the single most important factor in terms of block efficacy AND block safety is seeing the local spread on your realtime ultrasound image. Shows you that the local's getting where you want it to -- "halo sign" for a popliteal, e.g. -- and shows you it's not intravascular. This allows you to minimize your dose, which is the single best way to avoid LAST.