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 2024/10/15 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.