Landmark and PNS Guided Forearm Blocks

Vol 2 | Issue 1 | January-June 2021 | Page 67-71 | Surajit Giri


Authors: Surajit Giri [1]

[1] Department of Anaesthesia, Pragati Hospital & Research Centre, Sivasagar, Assam.

Address of Correspondence
Dr. Surajit Giri,
Department of Anaesthesia, Pragati Hospital & Research Centre, Sivasagar, Assam.
E-mail: drsurajit_1234@yahoo.com


Introduction

Elbow block is used to provide anaesthesia and analgesia for hand and forearm surgery [1]. Primarily it is used to supplement or augment a proximal brachial plexus block if it is partial or patchy. Therefore elbow block is termed as rescue block by many Anaesthesiologists. In recent years, Ultrasonography(USG) guided distal blocks are studied with proximal brachial plexus block to accelerates anaesthesia onset time and block consistency for forearm surgeries [2]. Good anatomical knowledge of forearm nerves (Fig A) is utmost mandatory to use elbow block as a primary anaesthetic technique for forearm and hand surgeries [3, 4].


References


1. Maga JM, Cooper L, Gebhard RE. Outpatient regional anaesthesia for upper extremity surgery update (2005 to present) distal to shoulder. Int Anaesthesia Clin 2012;50:47-55.
2. Lin E, Choi J, Hadzic A. Peripheral nerve blocks for outpatient surgery: Evidence-based indications. Curr Opin Anaesthesiology 2013;26:467-74.
3. Fredrickson MJ, Ting FS, Chinchanwala S, Boland MR. Concomitant infraclavicular plus distal median, radial, and ulnar nerve blockade accelerates upper extremity anaesthesia and improves block consistency compared with infraclavicular block alone. Br J Anaesth 2011;107:236-42.
4. Stranding S, editor. Upper arm. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. London: Churchill Livingstone; 2016. p. 837-61.
5. Gisela Meier,Johannes Buettner.Atlas of Peripheral Regional Anaesthesia: Anatomy & Technique.3rd edition.Thieme;2013.p.244-63.
6. Sehmbi H, Madjdpour C, Shah UJ, Chin KJ. Ultrasound guided distal peripheral nerve block of the upper limb: A technical review. J Anaesthesiol Clin Pharmacol 2015;31:296-307.
7. Fredrickson MJ, Price DJ. Analgesic effectiveness of ropivacaine 0.2% vs 0.4% via an ultrasound-guided C5-6 root/superior trunk perineural ambulatory catheter. Br J Anaesth 2009;103:434-9.
8. RA McCahon, NM Bedforth. Peripheral nerve block at the elbow and wrist. Continuing Education in Anaesthesia, Critical Care & Pain 2007; 7:42-44.


How to Cite this Article: Giri S | Landmark and PNS Guided Forearm Blocks | International Journal of Regional Anaesthesia | January-June 2021; 2(1): 67-71.

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