ULTRASOUND-GUIDED UPPER EXTREMITY PERIPHERAL NERVE BLOCKS
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Peripheral nerve blockade involves the injection of local anesthetic near a target nerve to inhibit neural transmission to produce surgical anesthesia in the distribution of the nerve and can provide postoperative analgesia.
The brachial plexus is a large network of nerves that extend from the neck through the axilla & innervate the upper extremity. It is formed by the nerves of C5-T1.
Blockade of the brachial plexus is indicated for procedures of the upper extremity. The location of blockade determines the site of anesthesia and analgesia.
BENEFITS
Decreased postoperative nausea and vomiting
Decreased postoperative pain
Decreased use of postoperative analgesics
Increased patient satisfaction
Decreased length of hospital stay
Avoidance of general anesthesia & its associated risks
CONTRAINDICATIONS
Patient refusal
Infection at injection site
Coagulopathy or other bleeding diathesis
Pre-existing neurologic disease
Uncooperative patient
Proven allergy to local anesthetics
POTENTIAL COMPLICATIONS
Local anesthetic systemic toxicity
Direct nerve injury
Vascular injury or hematoma
Infection
SUPPLIES
Patient monitoring devices
Ultrasound equipment & a high-frequency linear transducer
Appropriately-sized sterile gloves
Local anesthetic for local infiltration with a small-gauge needle
Local anesthetic of choice and syringes
Echogenic needle
Lubricating jelly
Probe cover
Sterile skin cleansing solution
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*Always have emergency equipment/drugs available*
