Upper Extremity Regional Anesthesia: Essentials for Your Practice

Contemporary data suggest that regional anesthesia for shoulder and arm/hand surgery improves early outcome measures such as superior analgesia, decreased opioid-related side effects, earlier readiness for discharge, and reduced frequency of unplanned hospital admission (see Supplemental Digital Content 1, http://links. lww.com/ASA/A276). Continuous perineural catheters consistently improve analgesia, and may facilitate earlier hospital discharge and rehabilitation after upper extremity surgery of moderate to severe pain intensity (see Supplemental Digital Content 2, http://links.lww.com/ ASA/A277). Furthermore, plexus-based regional anesthetic techniques generally result in superior analgesia as compared with surgeon-placed subacromial infusion or wound infiltration while avoiding concerns over local anesthetic-induced chondrolysis. Thus, brachial plexus regional anesthesia can positively affect outcome in patients undergoing upper extremity surgery.