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Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Procedural Guide for Assessing Axillary Body Temperature using a Digital Thermometer:
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Spinal Nerves: Plexus II01:21

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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

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Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...

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Axillary brachial plexus block.

Ashish R Satapathy1, David M Coventry

  • 1Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.

Anesthesiology Research and Practice
|July 1, 2011
PubMed
Summary
This summary is machine-generated.

The axillary approach to brachial plexus blockade offers safe and effective anesthesia for arm surgery. Advanced techniques, especially with ultrasound guidance, ensure reliable nerve blockade for improved patient outcomes.

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Area of Science:

  • Anesthesiology
  • Regional Anesthesia
  • Surgical Procedures

Background:

  • The axillary approach to brachial plexus blockade is a common technique for anesthesia of the upper limb.
  • Historically, single-injection techniques have had limitations in achieving complete blockade of all nerve territories.
  • Ensuring adequate anesthesia for elbow, forearm, and hand surgery is crucial for patient comfort and surgical success.

Purpose of the Study:

  • To review the efficacy and safety of the axillary approach for brachial plexus blockade.
  • To highlight the advantages of the axillary approach, particularly its safety profile.
  • To discuss the advancements in techniques, emphasizing ultrasound guidance for improved blockade reliability.

Main Methods:

  • Review of current literature and clinical practices regarding axillary brachial plexus blockade.
  • Comparison of single-injection versus multiple-injection techniques.
  • Emphasis on the role of nerve stimulation and ultrasound guidance in optimizing blockade success.

Main Results:

  • The axillary approach provides satisfactory anesthesia for surgeries below the elbow and covers specific cutaneous areas often missed by other methods.
  • It is considered the safest approach, avoiding phrenic nerve blockade and pneumothorax risk, making it suitable for day case surgery.
  • Multiple-injection techniques, particularly with ultrasound guidance, have significantly improved the success rates for complete and reliable blockade in all nerve territories.

Conclusions:

  • The axillary approach, especially with modern multiple-injection techniques and ultrasound guidance, offers a safe, effective, and reliable method for brachial plexus blockade.
  • This approach is ideal for day case surgery due to its favorable safety profile.
  • Continuous advancements are making complete and rapid arm blockade achievable.