naa a22 4500 510743676 CHVBK 20180411083037.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s12630-012-9874-6 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9874-6 Ultrasound-guided regional anesthesia for upper limb surgery [Elektronische Daten] [Marie-Josée Nadeau, Simon Lévesque, Nicolas Dion] Anesthésie locorégionale échoguidée pour la chirurgie du membre supérieur Purpose: The purpose of this module is to review the main ultrasound-guided approaches used for regional anesthesia of the upper limb. Principal findings: The anatomical configuration of the upper limb, with nerves often bundled around an artery, makes regional anesthesia of the arm both accessible and reliable. In-depth knowledge of upper limb anatomy is required to match the blocked territory with the surgical area. The interscalene block is the approach most commonly used for shoulder surgery. Supraclavicular, infraclavicular, and axillary blocks are indicated for elbow and forearm surgery. Puncture techniques have evolved dramatically with ultrasound guidance. Instead of targeting the nerves directly, it is now recommended to look for diffusion areas. Typically, local anesthetics are deposited around vessels, often as a single injection. Phrenic nerve block can occur with the interscalene and supraclavicular approaches. Ulnar nerve blockade is almost never achieved with the interscalene approach and not always present with a supraclavicular block. If ultrasound guidance is used, the risk for pneumothorax with a supraclavicular approach is reduced significantly. Nerve damage and vascular puncture are possible with all approaches. If an axillary approach is chosen, the consequences of vascular puncture can be minimized because this site is compressible. Conclusions: Upper limb regional anesthesia has gained in popularity because of its effectiveness and the safety profile associated with ultrasound-guided techniques. Canadian Anesthesiologists' Society, 2013 Nadeau Marie-Josée Département d'Anesthésie du CHU de Québec, Hôpital de l'Enfant-Jésus, Université Laval, 1401 18e rue, G1J 1Z4, Québec, QC, Canada aut Lévesque Simon Département d'Anesthésie du CHU de Québec, Hôpital de l'Enfant-Jésus, Université Laval, 1401 18e rue, G1J 1Z4, Québec, QC, Canada aut Dion Nicolas Département d'Anesthésie du CHU de Québec, Hôpital de l'Enfant-Jésus, Université Laval, 1401 18e rue, G1J 1Z4, Québec, QC, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 304-320 0832-610X 60:3<304 2013 60 12630 https://doi.org/10.1007/s12630-012-9874-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9874-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nadeau Marie-Josée Département d'Anesthésie du CHU de Québec, Hôpital de l'Enfant-Jésus, Université Laval, 1401 18e rue, G1J 1Z4, Québec, QC, Canada aut NATIONALLICENCE 700 1- Lévesque Simon Département d'Anesthésie du CHU de Québec, Hôpital de l'Enfant-Jésus, Université Laval, 1401 18e rue, G1J 1Z4, Québec, QC, Canada aut NATIONALLICENCE 700 1- Dion Nicolas Département d'Anesthésie du CHU de Québec, Hôpital de l'Enfant-Jésus, Université Laval, 1401 18e rue, G1J 1Z4, Québec, QC, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 304-320 0832-610X 60:3<304 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer