Anesthesia of the brachial plexus

WikiDoc Resources for Anesthesia of the brachial plexus

Articles

Most recent articles on Anesthesia of the brachial plexus

Most cited articles on Anesthesia of the brachial plexus

Review articles on Anesthesia of the brachial plexus

Articles on Anesthesia of the brachial plexus in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Anesthesia of the brachial plexus

Images of Anesthesia of the brachial plexus

Photos of Anesthesia of the brachial plexus

Podcasts & MP3s on Anesthesia of the brachial plexus

Videos on Anesthesia of the brachial plexus

Evidence Based Medicine

Cochrane Collaboration on Anesthesia of the brachial plexus

Bandolier on Anesthesia of the brachial plexus

TRIP on Anesthesia of the brachial plexus

Clinical Trials

Ongoing Trials on Anesthesia of the brachial plexus at Clinical Trials.gov

Trial results on Anesthesia of the brachial plexus

Clinical Trials on Anesthesia of the brachial plexus at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Anesthesia of the brachial plexus

NICE Guidance on Anesthesia of the brachial plexus

NHS PRODIGY Guidance

FDA on Anesthesia of the brachial plexus

CDC on Anesthesia of the brachial plexus

Books

Books on Anesthesia of the brachial plexus

News

Anesthesia of the brachial plexus in the news

Be alerted to news on Anesthesia of the brachial plexus

News trends on Anesthesia of the brachial plexus

Commentary

Blogs on Anesthesia of the brachial plexus

Definitions

Definitions of Anesthesia of the brachial plexus

Patient Resources / Community

Patient resources on Anesthesia of the brachial plexus

Discussion groups on Anesthesia of the brachial plexus

Patient Handouts on Anesthesia of the brachial plexus

Directions to Hospitals Treating Anesthesia of the brachial plexus

Risk calculators and risk factors for Anesthesia of the brachial plexus

Healthcare Provider Resources

Symptoms of Anesthesia of the brachial plexus

Causes & Risk Factors for Anesthesia of the brachial plexus

Diagnostic studies for Anesthesia of the brachial plexus

Treatment of Anesthesia of the brachial plexus

Continuing Medical Education (CME)

CME Programs on Anesthesia of the brachial plexus

International

Anesthesia of the brachial plexus en Espanol

Anesthesia of the brachial plexus en Francais

Business

Anesthesia of the brachial plexus in the Marketplace

Patents on Anesthesia of the brachial plexus

Experimental / Informatics

List of terms related to Anesthesia of the brachial plexus

The fact that the nerves of the brachial plexus are grouped together acts as a benefit as well. Local anesthetics such as lidocaine or bupivacaine can be injected in close proximity to these nerves, rendering an entire arm insensate and immobile. The process of injecting local anesthetic for this purpose is called regional nerve blockade or more simply, a nerve block, and it is a common procedure in anesthesia. After an onset time of approximately 10 to 15 minutes, the targeted arm will be fully anesthetized and ready for surgery. The patient can remain awake during the ensuing surgical procedure, or he can be sedated with medications or fully anesthetized with general anesthesia as the situation requires.

### Peripheral nerve blockade

[edit | edit source]

The use of peripheral nerve blockade (in this case, a "brachial plexus nerve block") offers several advantages when compared to general anesthesia or local anesthesia:

* The patient can remain awake and breathing on their own, thus protecting themselves from aspiration of stomach contents into the lungs. By avoiding general anesthesia, patients with adverse reactions to general anesthetics (viz. malignant hyperthermia, severe post-operative nausea and vomiting, known hypersensitivity to agents) can be successfully treated. Similarly, patients who experience nuisance side effects from general anesthesia such as nausea, vomiting, or excessive sleepiness can minimize these symptoms.
* There is no need to perform an endotracheal intubation, the procedure of inserting a breathing tube into the trachea. Occasionally, such intubation is unexpectedly difficult to perform, causing injury to the patient.
* The affected limb's sympathetic nerves are anesthetized, leading to vasodilation. This improves blood flow to the affected limb and makes microvascular surgical procedures technically simpler.
* The limb can remain numb for several hours after surgery, providing excellent pain relief.
* Deep and superficial structures of the limb are similarly anesthetized, allowing extensive surgical exploration and correction to occur. This is in contrast to locally injected local anesthetics, which tend only to numb superficial structures in the immediate vicinity of the injection.

### Brachial plexus blockade

[edit | edit source]

Brachial plexus blockade is the preferred anesthetic technique when:

* Surgery is expected to be limited either to a region between the midpoint of the humerus and the fingers (in which case the brachial plexus block should be either a supraclavicular, infra-clavicular, subcoracoid, or axillary block), OR surgery is expected to be limited to a region between the midpoint of the humerus and the shoulder (in which case the brachial plexus block should be an interscalene block). Because of the distribution of the local anesthetics on the various portions of the brachial plexus, surgeries crossing the midpoint of the humerus often reveal patchy, unanesthetized portions of the arm. Such procedures probably should not be performed under regional nerve block alone.

AND

* There are no contra-indications to a block such as infection at the intended injection site, significant anti-coagulation, allergy or hypersensitivity to local anesthetic medications, or disproportionate risk in the event of a local anesthetic toxic reaction (seizure) such as gastric aspiration in a patient who has not adequately fasted,

AND

* There will not be a need to perform a neurological examination immediately following the surgical procedure,

AND

* Patient prefers this technique over other available and reasonable approaches.

nl:Plexus brachialis blokkade

Template:WikiDoc Sources Anesthesiology