Approach and Troubleshooting to Upper Limb Blocks

The tremendous progress in surgical techniques has its foundations in the even more prodigious growth in anesthetic techniques. Regional anesthesia is an important aspect of this evolution. Regional anesthesia involves least possible interference with the physiology of the patient for a given surgical procedure, which improves of the safety and comfort of the patient. The advent of ultrasonography (USG)-guided nerve and plexus blocks has revolutionized the practice of anesthesia. Regional anesthesia was used in the past for a variety of upper limb procedures and surgeries but gradually began falling out of favor due to possible complications. The emergence of USG and its widespread availability revived the interest in a wide variety of nerve and plexus blocks for a spectrum of indications, therapeutic as well as diagnostic. Some of the common blocks practiced are Phrenic nerve block, Suprascapular nerve (SSN) block, Clavipectoral fascia block, Stellate ganglion block, Brachial plexus blocks via different approaches (Interscalene, Supraclavicular, Infraclavicular, and Axillary) as well as individual nerve blocks in the arm such as Radial, Median, and Ulnar nerve blocks. Ongoing research is continuously widening the horizon in which these blocks are being employed.