3 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 0
If every anesthesia practition-
er knew how to perform these
five basic block techniques
with ultrasound guidance,
there would be a massive
increase in patient access to
regional anesthesia. Each of
these blocks represents a
transferable skill, and practi-
tioners may choose to substi-
tute a block on the list with an
alternative block used for a
similar indication.
1. Interscalene brachial plexus. Everyone should be able to
offer a block for shoulder surgery, and the interscalene block is
still the gold standard. Other ultrasound-aided blocks have been
developed in the last few years, but a basic interscalene block is
something any anesthesiologist should be comfortable placing.
It has a long track record and it covers the entire site of pain for
every shoulder procedure, including total shoulder replace-
ments.
2. Infraclavicular brachial plexus. This block is good for
patients undergoing distal upper-limb surgery at the elbow, wrist
or hand. Some practitioners prefer to use an axillary brachial
plexus block, which may work just as well. For these surgeries,
you need a block of the brachial plexus below the clavicle close to
the shoulder. If you know how to do one of these two types of
• LET'S TALK Barriers to more widespread use of regional
anesthesia will be cleared through the constant sharing of best
practices.
ESSENTIAL SKILLS
5 Blocks Every Anesthesia Provider Should Know
