Ultrasound guided distal peripheral nerve block of the upper limb: A technical review.
Upper extremity surgery is commonly performed under regional anesthesia. The advent of ultrasonography has made performing upper extremity nerve blocks relatively easy with a high degree of reliability. The proximal approaches to brachial plexus block such as supraclavicular plexus block, infraclavicular plexus block, or the axillary block are favored for the most surgical procedures of distal upper extremity. Ultrasound guidance has however made distal nerve blocks of the upper limb a technically feasible, safe and efficacious option. In recent years, there has thus been a resurgence of distal peripheral nerve blocks to facilitate hand and wrist surgery. In this article, we review the technical aspects of performing the distal blocks of the upper extremity and highlight some of the clinical aspects of their usage.
Department of Anesthesia, Toronto Western Hospital, Toronto, Canada.
Herman
H
Sehmbi
Department of Anesthesia, Toronto Western Hospital, Toronto, Canada.
Caveh
C
Madjdpour
Department of Anesthesia, Toronto Western Hospital, Toronto, Canada.
Ushma Jitendra
UJ
Shah
Department of Anesthesia, Toronto Western Hospital, Toronto, Canada.
Ki Jinn
KJ
Chin
Distal; median; musculocutaneous; peripheral nerve blocks; radial; ulnar; ultrasound