[Regional anaesthesia in injuries of the upper extremity]

Regional anaesthesia has significant advantages compared to general anaesthesia with an opiate-based postoperative analgesia in injuries of the upper extremity. Severe pain may be considered a risk factor for the development of chronic postoperative pain syndromes in adults and children. Depending on the anticipated postoperative pain level, a catheter procedure should be used. Fractures of the upper extremity are common and may also be associated with seemingly minor injuries with a high postoperative pain level. Nerve damage can be caused mainly by traumatic fractures, or iatrogenically during surgical procedures. Reduced possible neurological evaluability should not prevent the excellent pain control which regional anesthesia can provide. Since the brachial plexus is predominantly responsible for the sensory innervation of the entire upper extremity, therefore all known block techniques in regional anaesthesia apply. Since the introduction of ultrasound in regional anaesthesia (USGRA), older methods like the supraclavicular approach, which were previously banned due to high complication rates, are now being rediscovered. Both new and old blockade methods are much more effective and safe with ultrasound support because of the rapid visualization of the anatomy and needle.