Regional Anesthesia for Wrist and Hand Surgery

Abstract

Regional anesthesia techniques can be used for primary surgical anesthesia and postoperative analgesia, particularly for patients with a history of sensitivity or poor response to general anesthesia and opioid-based analgesia. The use of high-resolution ultrasound for the localization of peripheral nerves and guidance of local anesthetic injection has some reported advantages over more traditional techniques, specifically in the realm of efficiency and challenging clinical situations. Available evidence, however, does not entirely support the abandonment of other techniques. Continuous peripheral nerve catheters are being used to extend the duration of regional analgesia in selected patients and procedures. Intravenous regional anesthesia continues to combine simplicity and reliability for many hand and wrist procedures of appropriate duration. Allocating resources to maximize parallel, rather than serial, anesthetic care provides the best opportunity for regional anesthesia to improve the efficient functioning of the operating and recovery rooms.

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