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Review
. 2023 Jul 1;91(1):187-193.
doi: 10.1097/SAP.0000000000003592.

Regional Anesthesia in Upper-Limb Surgery

Lachlan McLennan  1 , Morgan Haines  2 , David Graham  3 , Timothy Sullivan  1 , Richard Lawson, Brahman Sivakumar  1
Affiliations
Review

Regional Anesthesia in Upper-Limb Surgery

Lachlan McLennan et al. Ann Plast Surg. .

Abstract

Background: Local and regional anesthesia is associated with numerous clinical and institutional advantages relative to general anesthesia. As anesthesiologists and surgeons increasingly integrate local and regional anesthesia into their clinical practice, an understanding of the principles, evolution, and trends underpinning modern anesthetic techniques continues to be relevant.

Methods: A review of the literature in databases Medline, PubMed, and EMBASE identified recent developments, ongoing trends, and historical milestones in upper-limb regional anesthesia.

Results: Advances in regional anesthetic techniques in the last century have led to reduced postoperative pain, improved safety, and improved outcomes in upper-limb surgery. The development of ultrasound-guided techniques, as well as pharmacological advances in local anesthetic drugs and adjuncts, has further advanced the role of regional anesthesia. Wide-awake local anesthesia with no tourniquet has allowed certain procedures to be performed on select patients in outpatient and low-resource settings.

Conclusions: This review provides an overview of local and regional anesthesia in the upper-limb from its historical origins to its contemporary applications in upper-limb surgery, particularly during the COVID-19 pandemic.

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Conflict of interest statement

Conflicts of interest and sources of funding: none declared.

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