Regional Anesthesia for Orthopedic Surgeries: A Guide for Upper and Lower Extremity Procedures

Regional anesthesia has become a cornerstone in orthopedic surgeries due to its ability to provide precise, localized pain relief while minimizing the systemic risks associated with general anesthesia and opioid use. This review aims to provide a compact guide for anesthesia trainees and practicing anesthesiologists on the use of regional anesthesia techniques for upper and lower extremity procedures.

This guide outlines the main regional block options for orthopedic surgeries, detailing the targeted anatomy, common surgical indications, important adjacent structures, and potential complications for each technique. Key blocks for upper extremity surgeries include interscalene, supraclavicular, infraclavicular, axillary, and intercostobrachial blocks, while lower extremity techniques encompass femoral, adductor canal, sciatic, popliteal, and lumbar plexus blocks. Advances in ultrasound guidance have enhanced the safety and efficacy of these techniques, making them indispensable for modern anesthesiology practice. By mastering these approaches, providers can optimize patient outcomes, expand their skillset, and contribute to enhanced perioperative care in orthopedic surgery.