Complications of Regional Anesthesia

pp 121-148

Complications of Brachial Plexus Anesthesia

  • Brendan T. FinucaneAffiliated withDepartment of Anesthesiology and Pain Medicine, University of Alberta
  • , Ban C. H. TsuiAffiliated withDepartment of Anesthesiology and Pain Medicine, University of AlbertaUniversity of Alberta Hospital and Stollery Children’s Hospital

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In 1884, Carl Köller1 discovered the local anesthetic properties of cocaine while working with Sigmund Freud. This was one of the most important discoveries in the history of medicine. In that very same year, Halsted2 performed the first documented case of brachial plexus anesthesia at Johns Hopkins hospital when he injected the brachial plexus in the supraclavicular region under direct vision. The first percutaneous approach to the brachial plexus was performed by Hirschel3 in 1911, when he injected local anesthetic drugs into the axillary sheath. In that same year, Kulenkampff4 described the classic supraclavicular approach to the brachial plexus. Axillary approaches to the brachial plexus have always been more popular than supraclavicular techniques, perhaps because the risks seemed to be fewer.