Principles and Techniques of Common Surgical Nerve Blocks: Brachial Plexus Block

Overview

The brachial plexus block is a commonly performed regional anesthesia technique used to provide pain relief or surgical anesthesia for upper limb procedures.

Types of Brachial Plexus Blocks

• Interscalene Block: Ideal for shoulder and upper arm surgery.
• Supraclavicular Block: Provides anesthesia to the upper limb, including the elbow and distal structures.
• Infraclavicular Block: Useful for procedures involving the hand and forearm.
• Axillary Block: Commonly used for forearm, wrist, and hand surgeries.

Indications

Brachial plexus blocks are indicated for various procedures, including:

• Orthopedic surgeries of the upper limb
• Trauma management in the upper extremities
• Postoperative analgesia
• Chronic pain management

Procedural Steps

Preoperative Preparation

Perform a thorough patient assessment, obtain consent, and ensure aseptic conditions.

Techniques

1. Position the patient appropriately.
2. Identify anatomical landmarks and use ultrasound guidance for precision.
3. Insert the needle, ensuring correct positioning via nerve stimulation or ultrasound.
4. Inject the local anesthetic slowly, monitoring patient response.

Complications

Potential complications include:

• Local anesthetic toxicity
• Nerve damage
• Pneumothorax (especially in supraclavicular block)
• Hematoma formation

Conclusion

The brachial plexus block is an effective anesthesia technique for upper limb procedures, enhancing patient comfort and reducing systemic anesthetic requirements.