Upper limb nerve blocks

David M. Coventry, Pavan Kumar B C Raju

    Research output: Contribution to journalArticle

    Abstract

    Brachial plexus blockade is commonly used for a variety of upper limb surgical procedures and the introduction of ultrasound guidance has led to re-evaluation of many of the approaches. Large-scale studies examining both efficacy and complications of ultrasound-guided techniques compared with nerve stimulation are lacking, but there is a growing body of research to support the routine use of ultrasound. Interscalene block remains the approach of choice for shoulder surgery but phrenic nerve blockade remains common, even using low volumes of local anaesthetic. Of the currently available studies comparing the other approaches, there seems to be little difference in efficacy between axillary, supraclavicular and infraclavicular approaches for elbow, forearm and hand surgery when equivalent levels of expertise are used. Recently, the growth of ambulatory surgery has influenced the increased use of peripheral nerve blocks for analgesia. The major features influencing block choice and performance are discussed here.

    Original languageEnglish
    Pages (from-to)187-191
    Number of pages5
    JournalAnaesthesia and Intensive Care Medicine
    Volume17
    Issue number4
    Early online date23 Feb 2016
    DOIs
    Publication statusPublished - Apr 2016

      Fingerprint

    Keywords

    • Brachial plexus block
    • regional anaesthesia
    • technique
    • ultrasound

    Cite this