Friday, May 13, 2011

ANESTHESIA LOCAL REGIONAL



















5.4 REGIONAL ANAESTHESIA
Technique used for the interruption of sensory pathways involves
the use of local anaesthetic agents at different sites in the
nervous system and can be used -

1. On mucosal surfaces
2. for subcutaneous infiltration
3. for nerve blocks

UPPER LIMB

Brachial plexus blocks above the clavicle include inter-scalene (ISB) and supraclavicular is performed at the level of the C6 transverse process, and 30 ml of LA is injected between the fascia of the anterior and middle scalene muscles after identification of the C5-C6 nerve roots. Rapid anesthesia of the superficial cervical plexus and upper toots of the brachial plexus ensures, so the technique is particularly well suited for shoulder procedures.

Brachial plexus blocks below the clavicle include infraclavicular (IFCB) and axillary (AXB) blocks.

The median nerve is located just medial to the brachial artery pulse, 2 to 3 cm proximal to the elbow flexion crease, and the radial nerve is located as it courses around the lateral supracondylar ridge of the humerus 3 to 4 cm proximal to the elbow crease. Each blocked with 5 to 10 ml of LA.

Wrist block of the three peripheral nerves is performed with 3 to 5 ml of LA per nerve, as shown. Finally, digital block can be performed for individual fingers with non-epinephrine-containing LA just distal to the metacarpophalangeal joint.

Any questions be snt to drmmkapur@gmail.com
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