Epidural Anesthesia Essay

The International Association for the Study of Pain 's widely used definition states: "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage."1

Pain after orthopedic surgery is usually very intense. Managing pain after upper limb procedures poses a great challenge to both anesthesiologists and orthopedic surgeons. To counter this and improve analgesia and facilitate mobilization, regional anesthesia can be made of use. Relatively complication free axillary approach to the brachial plexus is often used, either as an adjunct to general anaesthesia or as the primary anaesthetic in forearm and hand surgeries. The use of an axillary block as the primary anaesthetic

Regional anesthesia of the upper limb can be achieved by blocking the brachial plexus at varying levels along the course of the trunks, divisions, cords and terminal branches. The four most common techniques used in the clinical setting are the interscalene block, the supraclavicular block, the infraclavicular block, and the axillary block. Each approach has its own unique set of advantages, disadvantages, and indications for use. The supraclavicular block is most effective for anesthesia of the mid-humerus and below. Infraclavicular blocks are useful for procedures requiring continuous anesthesia. Axillary blocks provide effective anesthesia distal to the elbow, and interscalene blocks are best suited for the shoulder and proximal upper limb.