RT Book, Section
A1 Neal, Joseph M.
A1 Gurkan, Yavuz
A2 Hadzic, Admir
SR Print(0)
ID 1141739383
T1 Cutaneous Blocks for the Upper Extremity
T2 Hadzic's Textbook of Regional Anesthesia and Acute Pain Management, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071717595
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1141739383
RD 2024/04/24
AB Although  most  upper  extremity  regional  anesthesia  is  accomplished  by  means  of  various  approaches  to  the  brachial  plexus,  there  are  occasions  when  individual  terminal  nerves  or  their  branches  are  blocked  selectively.  There  are  generally  three  instances  in  which  the  anesthesiologist  desires  to  perform  these  selective  nerve  blocks.  First,  some  surgical  sites  are  partially  innervated  by  sensory  nerves  that  are  not  part  of  the  brachial  plexus  or  not  consistently  anesthetized  with  plexus  blocks.  This  chapter  describes  how  and  when  to  anesthetize  the  most  common  of  these  nerves—the  supraclavicular,  the  suprascapular,  and  the  intercostobrachial.  The  second  indication  is  when  the  block  of  the  entire  brachial  plexus  block  is  not  necessary  for  the  planned  procedure.  In  this  case,  selective  upper  extremity  cutaneous  anesthesia  or  analgesia  may  involve  blocking  terminal  nerves  (radial,  median,  or  ulnar  nerves)  or  their  branches  (lateral  and  medial  antebrachial  cutaneous  nerves)  distally  at  the  elbow.  A  final  and  controversial  indication  for  selective  upper  extremity  nerve  blocks  is  their  use  as  a  supplement  to  an  incomplete  brachial  plexus  block.