TY - JOUR
T1 - Upper Limb Nerve Blocks
AU - Raju, Pavan Kumar B.C.
AU - Bowness, James
PY - 2019/4
Y1 - 2019/4
N2 - Brachial plexus blockade is used for a variety of upper limb surgical procedures. Ultrasound guidance is generally considered to be the gold-standard technique, although large-scale studies examining efficacy and complications of ultrasound-guided techniques compared with nerve stimulation are still needed. Interscalene block remains the approach of choice for shoulder surgery, although phrenic nerve blockade is 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. The major features influencing block choice and performance are discussed.
AB - Brachial plexus blockade is used for a variety of upper limb surgical procedures. Ultrasound guidance is generally considered to be the gold-standard technique, although large-scale studies examining efficacy and complications of ultrasound-guided techniques compared with nerve stimulation are still needed. Interscalene block remains the approach of choice for shoulder surgery, although phrenic nerve blockade is 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. The major features influencing block choice and performance are discussed.
KW - Brachial plexus block
KW - regional anaesthesia
KW - technique
KW - ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85063495025&partnerID=8YFLogxK
U2 - 10.1016/j.mpaic.2019.01.013
DO - 10.1016/j.mpaic.2019.01.013
M3 - Review article
SN - 1472-0299
VL - 20
SP - 224
EP - 229
JO - Anaesthesia and Intensive Care Medicine
JF - Anaesthesia and Intensive Care Medicine
IS - 4
ER -