Anaes Vivas · Regional anaesthesia
Upper limb regional anaesthesia: brachial plexus approaches — viva
Structured oral examination station for upper-limb-regional-blocks.
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Study tools
Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
Clinical stem centred on upper limb regional blocks. Crisis focus: LAST after interscalene or supraclavicular block.
Opening
State the one-line plan: match the brachial plexus approach to surgical territory — interscalene for shoulder (accepting phrenic paresis), supraclavicular for arm and forearm (with pneumothorax risk), infraclavicular for below-elbow work and catheters, axillary for the hand with the musculocutaneous blocked separately — every block under ultrasound with fractionated injection, dose calculated on lean body weight, and lipid 1.5 mL/kg drawn up for LAST[1][4][5].
References7ShowHide
- [1]Neal JM, Barrington MJ, Fettiplace MR, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. Regional Anesthesia and Pain Medicine, 2018.PMID 29356773
- [2]Horlocker TT, Vandermeuelen E, Kopp SL, et al. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Fourth Edition). Regional Anesthesia and Pain Medicine, 2018.PMID 29561531
- [3]Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British Journal of Anaesthesia, 2015.PMID 26556848
- [4]Muir D, Cara J, Morris R, et al. Supraclavicular versus infraclavicular brachial plexus block in upper limb orthopaedic surgery: a systematic review and meta-analysis of randomised controlled trials. European Journal of Orthopaedic Surgery and Traumatology, 2024.PMID 39287814
- [5]Petrar SD, Seltenrich ME, Head SJ, Schwarz SK Hemidiaphragmatic paralysis following ultrasound-guided supraclavicular versus infraclavicular brachial plexus blockade: a randomized clinical trial. Regional Anesthesia and Pain Medicine, 2015.PMID 25650633
- [6]Renes SH, Rettig HC, Gielen MJ, et al. Ultrasound-guided low-dose interscalene brachial plexus block reduces the incidence of hemidiaphragmatic paresis. Regional Anesthesia and Pain Medicine, 2009.PMID 19920426
- [7]Mangal V, Meena C, Meena K, et al. Comparison of USG-Guided Supraclavicular Brachial Plexus Block by Single-Point Versus Multiple-Point Injection Technique: A Prospective Randomized Trial. Cureus, 2023.PMID 38111430