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Brachial Plexus Nerve Block
Jason M. Lewis, MD; Rafael Vazquez, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Synonyms

              • Brachial plexus block (BPB)
            • Definitions

              • Nerve block along brachial plexus that results in analgesia to upper extremity structures and vasodilation of blood vessels
                • Does not cover intercostobrachial nerve (T2 dermatome)
                • Can be performed at various locations along trunks, divisions, and cords of plexus
                • Lasts 6-20 hours, depending on local anesthetic used

            PREPROCEDURE

            • Indications

              • Contraindications

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Equipment Preparation

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Expected Outcome

                              • Things to Do

                                • Things to Avoid

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      Selected References

                                      1. Gedikoglu M et al: Comparison of sedoanalgesia versus ultrasound-guided supraclavicular brachial plexus block for the prevention of the pain during endovascular treatment of dysfunctional hemodialysis fistulas. Cardiovasc Intervent Radiol. 42(10):1391-7, 2019
                                      2. Macfarlane AJR et al: Regional anesthesia for vascular surgery: does the anesthetic choice influence outcome? Curr Opin Anaesthesiol. 32(5):690-6, 2019
                                      3. Tran Q et al: Diaphragm-sparing nerve blocks for shoulder surgery, revisited. Reg Anesth Pain Med. ePub, 2019
                                      4. Shemesh D et al: General, regional or local anesthesia for successful radial cephalic arteriovenous fistula. J Vasc Access. 18(Suppl. 1):24-8, 2017
                                      5. Halaszynski TM: Ultrasound brachial plexus anesthesia and analgesia for upper extremity surgery: essentials of our current understanding, 2011. Curr Opin Anaesthesiol. 24(5):581-91, 2011
                                      6. Neal JM et al: Upper extremity regional anesthesia: essentials of our current understanding, 2008. Reg Anesth Pain Med. 34(2):134-70, 2009
                                      7. Koff MD et al: Severe brachial plexopathy after an ultrasound-guided single-injection nerve block for total shoulder arthroplasty in a patient with multiple sclerosis. Anesthesiology. 108(2):325-8, 2008
                                      8. Laskowski IA et al: Regional nerve block allows for optimization of planning in the creation of arteriovenous access for hemodialysis by improving superficial venous dilatation. Ann Vasc Surg. 21(6):730-3, 2007
                                      9. Shemesh D et al: Sympathectomy-like effects of brachial plexus block in arteriovenous access surgery. Ultrasound Med Biol. 32(6):817-22, 2006
                                      10. Rodríguez J et al: High doses of mepivacaine for brachial plexus block in patients with end-stage chronic renal failure. A pilot study. Eur J Anaesthesiol. 18(3):171-6, 2001
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Preprocedure

                                          • Procedure

                                            • Post Procedure

                                              • Outcomes

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Brachial plexus block (BPB)
                                                • Definitions

                                                  • Nerve block along brachial plexus that results in analgesia to upper extremity structures and vasodilation of blood vessels
                                                    • Does not cover intercostobrachial nerve (T2 dermatome)
                                                    • Can be performed at various locations along trunks, divisions, and cords of plexus
                                                    • Lasts 6-20 hours, depending on local anesthetic used

                                                PREPROCEDURE

                                                • Indications

                                                  • Contraindications

                                                    • Getting Started

                                                      PROCEDURE

                                                      • Patient Position/Location

                                                        • Equipment Preparation

                                                          • Procedure Steps

                                                            • Findings and Reporting

                                                              • Alternative Procedures/Therapies

                                                                POST PROCEDURE

                                                                • Expected Outcome

                                                                  • Things to Do

                                                                    • Things to Avoid

                                                                      OUTCOMES

                                                                      • Problems

                                                                        • Complications

                                                                          Selected References

                                                                          1. Gedikoglu M et al: Comparison of sedoanalgesia versus ultrasound-guided supraclavicular brachial plexus block for the prevention of the pain during endovascular treatment of dysfunctional hemodialysis fistulas. Cardiovasc Intervent Radiol. 42(10):1391-7, 2019
                                                                          2. Macfarlane AJR et al: Regional anesthesia for vascular surgery: does the anesthetic choice influence outcome? Curr Opin Anaesthesiol. 32(5):690-6, 2019
                                                                          3. Tran Q et al: Diaphragm-sparing nerve blocks for shoulder surgery, revisited. Reg Anesth Pain Med. ePub, 2019
                                                                          4. Shemesh D et al: General, regional or local anesthesia for successful radial cephalic arteriovenous fistula. J Vasc Access. 18(Suppl. 1):24-8, 2017
                                                                          5. Halaszynski TM: Ultrasound brachial plexus anesthesia and analgesia for upper extremity surgery: essentials of our current understanding, 2011. Curr Opin Anaesthesiol. 24(5):581-91, 2011
                                                                          6. Neal JM et al: Upper extremity regional anesthesia: essentials of our current understanding, 2008. Reg Anesth Pain Med. 34(2):134-70, 2009
                                                                          7. Koff MD et al: Severe brachial plexopathy after an ultrasound-guided single-injection nerve block for total shoulder arthroplasty in a patient with multiple sclerosis. Anesthesiology. 108(2):325-8, 2008
                                                                          8. Laskowski IA et al: Regional nerve block allows for optimization of planning in the creation of arteriovenous access for hemodialysis by improving superficial venous dilatation. Ann Vasc Surg. 21(6):730-3, 2007
                                                                          9. Shemesh D et al: Sympathectomy-like effects of brachial plexus block in arteriovenous access surgery. Ultrasound Med Biol. 32(6):817-22, 2006
                                                                          10. Rodríguez J et al: High doses of mepivacaine for brachial plexus block in patients with end-stage chronic renal failure. A pilot study. Eur J Anaesthesiol. 18(3):171-6, 2001