Terminal Nerve Blocks of the Upper Extremity

Abstract

Peripheral nerve blocks in the upper extremity are particularly valuable as rescue blocks to supplement surgical anesthesia (e.g., in the case of incomplete/insufficient block) and to provide long-lasting selective analgesia in the postoperative period. In addition, when localized surgical procedures are performed involving a region supplied by a single nerve, it is possible to produce neural blockade of the terminal nerves in the periphery, rather than targeting the entire brachial plexus. Single nerve blocks allow for lower doses of local anesthetic, thus reducing the risk of systemic toxicity. This chapter will discuss nerve stimulation- and ultrasound-guided approaches for blockade of the median, radial, and ulnar nerves.