Regional anesthesia for elbow and hand surgery

Abstract

Brachial plexus (C5-T1) innervates almost all upper extremity dermatomes and all osteotomes. Anesthesia and analgesia for elbow and hand procedures target the brachial plexus distal to roots/trunks (Fig. 1). Supra- and infraclavicular approaches anesthetize trunks/divisions and cords of plexus, respectively, and axillary approach anesthetizes four terminal nerves (musculocutaneous, median, radial, and ulnar). Supra-/infraclavicular and axillary approaches are suitable for surgeries distal to mid-humerus. Individual peripheral nerve branches may also be targeted.