Ultrasound-guided Regional Anesthesia for Procedures of the Upper Extremity

Overview

Journal Anesthesiol Res Pract

Publisher Wiley

Specialty Anesthesiology

Date 2011 Jul 1

PMID 21716734

Citations 6

Authors

Farheen Mirza

Anthony R Brown

Affiliations

Soon will be listed here.

Abstract

Anesthesia options for upper extremity surgery include general and regional anesthesia. Brachial plexus blockade has several advantages including decreased hemodynamic instability, avoidance of airway instrumentation, and intra-, as well as post-operative analgesia. Prior to the availability of ultrasound the risks of complications and failure of regional anesthesia made general anesthesia a more desirable option for anesthesiologists inexperienced in the practice of regional anesthesia. Ultrasonography has revolutionized the practice of regional anesthesia. By visualizing needle entry throughout the procedure, the relationship between the anatomical structures and the needle can reduce the incidence of complications. In addition, direct visualization of the spread of local anesthesia around the nerves provides instant feedback regarding the likely success of the block. This review article outlines how ultrasound has improved the safety and success of brachial plexus blocks. The advantages that ultrasound guidance provides are only as good as the experience of the anesthesiologist performing the block. For example, in experienced hands, with real time needle visualization, a supraclavicular brachial plexus block has changed from an approach with the highest risk of pneumothorax to a block with minimal risks making it the ideal choice for most upper extremity surgeries.

Citing Articles

Comparison of the Effects of Dexamethasone and Magnesium Sulfate Used as Adjuvants on Infraclavicular Brachial Plexus Nerve Block: A Prospective, Double-Blinded Randomized Controlled Trial.

Gunes M, Gunes H Cureus. 2025; 17(2):e78794.

PMID: 40078252 PMC: 11897671. DOI: 10.7759/cureus.78794.

Spotlight on Nerves: Portable Multispectral Optoacoustic Imaging of Peripheral Nerve Vascularization and Morphology.

Justel D, Irl H, Hinterwimmer F, Dehner C, Simson W, Navab N Adv Sci (Weinh). 2023; 10(19):e2301322.

PMID: 37092572 PMC: 10323611. DOI: 10.1002/advs.202301322.

Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures.

Lee R, Lee D, Ramamurti P, Fassihi S, Heyer J, Stadecker M Eur J Trauma Emerg Surg. 2021; 48(6):4569-4576.

PMID: 34050773 PMC: 8164052. DOI: 10.1007/s00068-021-01704-1.

The effectiveness of additional thoracic paravertebral block in improving the anesthetic effects of regional anesthesia for proximal humeral fracture surgery in elderly patients: study protocol for a randomized controlled trial.

Wang X, Zhang H, Xie Z, Zhang Q, Jiang W, Zhang J Trials. 2020; 21(1):204.

PMID: 32075674 PMC: 7031908. DOI: 10.1186/s13063-020-4078-9.

A Systematic Review of Postoperative Pain Outcome Measurements Utilised in Regional Anesthesia Randomized Controlled Trials.

Pushpanathan E, Setty T, Carvalho B, Sultan P Anesthesiol Res Pract. 2018; 2018:9050239.

PMID: 30151005 PMC: 6087609. DOI: 10.1155/2018/9050239.

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