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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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Spinal Nerves: Plexus II01:21

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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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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.
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Nerve Blocks: Part I. Upper Extremity.

Jacqueline L Yurgil1, Chad D Hulsopple2, Jeffrey C Leggit2

  • 1Family Medicine Residency, Offutt Air Force Base, NE, USA.

American Family Physician
|May 29, 2020
PubMed
Summary
This summary is machine-generated.

Family physicians use nerve blocks for various procedures, offering effective regional anesthesia. Ultrasound-guided techniques enhance safety and efficiency for upper extremity procedures.

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Area of Science:

  • Anesthesiology
  • Emergency Medicine
  • Family Medicine

Background:

  • Procedural anesthesia is frequently administered by family physicians for diverse conditions.
  • Nerve blocks offer regional anesthesia with reduced anesthetic volume compared to general anesthesia.
  • Understanding anatomy is crucial for effective nerve blocks and complication avoidance.

Purpose of the Study:

  • To review procedural anesthesia techniques utilized by family physicians.
  • To highlight the benefits and methods of nerve blocks, particularly ultrasound-guided approaches.
  • To inform physicians about nerve block options for patient counseling.

Main Methods:

  • Review of nerve block techniques including landmark-based, nerve stimulation, and ultrasonography.
  • Focus on ulnar, median, and radial nerve blocks at the wrist and elbow.
  • Emphasis on ultrasound-guided nerve blocks.

Main Results:

  • Ultrasound-guided nerve blocks demonstrate superiority in reducing procedural complications and time.
  • Nerve blocks provide effective anesthesia for a broad spectrum of upper extremity procedures.
  • Knowledge of these techniques enables better patient counseling.

Conclusions:

  • Nerve blocks are a valuable tool for family physicians performing procedural anesthesia.
  • Ultrasound guidance significantly improves the safety and efficiency of nerve blocks.
  • Physicians should integrate knowledge of advanced nerve block techniques into their practice.