Nerve and plexus block

(1) Cervical plexus block Superficial cervical plexus block can be used for superficial supraclavicular neck surgery, but deep cervical surgery, such as thyroid surgery, carotid endarterectomy, still need to be used for deep cervical plexus block. However, due to the innervation of the posterior four cranial nerves in the neck, the effect of cervical plexus block alone is not perfect, and adjuvant drugs can be used to relieve pain.

(2) Brachial plexus block includes five approaches: transcervical brachial plexus block, intermuscular sulcus block, supraclavicular brachial plexus block, subclavian brachial plexus block, axillary brachial plexus block. The effect of the five brachial plexus approaches varies with the anatomy of each part, and the innervation of each part of the upper limb is also different. Therefore, the most appropriate approach should be selected according to the innervation of the surgical site.

(3) Upper limb nerve block Upper limb nerve block is mainly suitable for forearm or hand surgery, and can also be used as a remedy for incomplete brachial plexus block. These include median nerve block, ulnar nerve block and radial nerve block. It can be at the elbow or wrist block, or interdigital nerve block if finger surgery is performed.

(4) Lower extremity nerve block The lumbar plexus and sacral plexus should be blocked in all lower extremity anesthesia. It is not widely used in clinic because of the need of multiple injection and inconvenient operation. However, lumbosacral plexus block may be used when the area of anesthesia required is limited or when intraspinal anesthesia is contraindicated. In addition, lumbosacral plexus block can also be used as an adjunct to general anesthesia for postoperative analgesia.

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