Upper Extremity Regional Anesthesia Techniques: A Comprehensive Review for Clinical Anesthesiologists

Publication date: Available online 20 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, Sudipta Sen, Nadia Hernandez, Johanna Blair De Haan, Rebecca A. Budish, Christopher Bailey, Joseph Ragusa, Pankaj Thakur, Vwaire Orhurhu, Ivan Urits, Elyse M. Cornett, Alan David KayeAbstractSurgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in clinical setting include the interscalene, supraclavicular, infraclavicular and axillary brachial plexus blocks. These blocks are most commonly performed with the use of ultrasound guided techniques whereby analgesia is achieved by anesthetizing the brachial plexus at different levels such as the roots, divisions, cords and branches. Additional regional anesthetic techniques for upper extremity surgery include wrist, intercostobrachial, and digital nerve blocks, which are most frequently performed using landmark anatomical techniques. This review provides a comprehensive summary of each of these blocks including anatomy, best practice techniques, and potential complications.

Source: Best Practice and Research Clinical Anaesthesiology - July 21, 2019 Category: Anesthesiology Source Type: research