Perspective Axillary brachial plexus block is most effective for surgical procedures distal to the elbow. Some patients can undergo procedures on the elbow or lower humerus with an axillary technique, but strong consideration should be given to a supraclavicular block…
Perspective Infraclavicular brachial plexus block is useful for both single-injection and continuous infusion techniques. This technique results in a sensory and motor block similar to a traditional axillary approach, albeit with certain advantages. Thus it is most useful for patients…
Key Points High-frequency, 38-mm broadband linear array transducer is preferred for this block. For catheter insertion, the Tuohy needle is usually used. The catheter is placed beneath the transverse scapular ligament around the suprascapular nerve (SSN). The correct position of…
Perspective Supraclavicular block provides anesthesia of the entire upper extremity in the most consistent, efficient manner of any brachial plexus technique. It is the most effective block for all portions of the upper extremity and is carried out at the…
Perspective Interscalene block (classic anterior approach) is especially effective for surgery of the shoulder or upper arm because the roots of the brachial plexus are most easily blocked with this technique. Frequently the ulnar nerve and its more peripheral distribution…
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Equipment Needles, catheters, and syringes Effective regional anesthesia requires comprehensive knowledge of equipment—that is, the needles, syringes, and catheters that allow the anesthetic to be injected into the desired area. In early years, regional anesthesia found many variations in the…
Key Points Neonates and infants are more prone to developing systemic toxicity to local anesthetics (LAs), particularly amide LAs, compared with older children and adults. This is due to reduced plasma concentration of α 1 -acid glycoprotein with higher unbound…
Regional anesthesia is a fast-growing field with application in a wide range of surgical procedures. Better technique with the help of ultrasound, better and safer local anesthetics, and better drug delivery systems for continuous anesthesia all helped in gaining the…