frequent procedures
 

BRACHIAL PLEXUS BLOCK
Brachial plexus block is frequently used for controlling pain that radiates into the upper extremity on the ipsilateral side.

INDICATIONS:
1. Reflex sympathetic dystrophy of the upper extremity.
2. Brachial plexopathy.
3. Causalgia.
4. Severe spine pain and neuromas.

TYPES: There are different types of brachial plexus block approach. Brachial plexus block can be done by accessing the brachial plexus via an axillary approach, an interscalene approach, a supraclavicular approach, or an infraclavicular approach. The most common approach includes the axillary approach and the interscalene approach, depending on the clinical indications of the procedure. In this procedure, the patient is supine and the neurovascular bundle is palpated in the axillary region as proximally as feasible, and then accessed with a tiny needle following local anesthetic infiltration into the area, followed by injection of about 40-cc of local anesthetic and a small amount of Depo-steroid. The actual injection is often with minimal discomfort, and tolerable, resulting in the patient describing immediate pain relief in the upper extremity as well as improved perfusion to the skin and improvement in stiffness of stiff joints of the fingers and hands on the affected side.

CONTRAINDICATIONS: Contraindications include anticoagulation and allergies to contrast dye, as well as pregnancy or when the patient suspects that she may be pregnant. Anticoagulation should be stopped at about three days prior to the procedure being done.

COMPLICATIONS: Complications are minimal and rare, and the procedure is often uneventful and smooth.

SEDATIVES: Some patients may require sedatives or pre-medication, due to anxiety, for this procedure, otherwise the procedure is benign, and does not necessitate any sedation.

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