Article Text

Download PDFPDF
Upper Extremity Regional Anesthesia: Essentials of Our Current Understanding, 2008
  1. Joseph M. Neal, MD*,
  2. J.C. Gerancher, MD,
  3. James R. Hebl, MD,
  4. Brian M. Ilfeld, MD, MS§,
  5. Colin J.L. McCartney, MBChB,
  6. Carlo D. Franco, MD and
  7. Quinn H. Hogan, MD#
  1. From the *Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA;
  2. Department of Anesthesiology, Wake Forest University, Winston-Salem, NC;
  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN;
  4. §Department of Anesthesiology, University of California, San Diego, San Diego, CA;
  5. Department of Anesthesiology, University of Toronto, Toronto, Ontario, Canada;
  6. Department of Anesthesiology, Rush University Medical Center, Chicago, IL; and
  7. #Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.
  1. Address correspondence to: Joseph M. Neal, MD, 1100 Ninth Ave (B2-AN), Seattle, WA 98101 (e-mail: anejmn{at}


Brachial plexus blockade is the cornerstone of the peripheral nerve regional anesthesia practice of most anesthesiologists. As part of the American Society of Regional Anesthesia and Pain Medicine's commitment to providing intensive evidence-based education related to regional anesthesia and analgesia, this article is a complete update of our 2002 comprehensive review of upper extremity anesthesia. The text of the review focuses on (1) pertinent anatomy, (2) approaches to the brachial plexus and techniques that optimize block quality, (4) local anesthetic and adjuvant pharmacology, (5) complications, (6) perioperative issues, and (6) challenges for future research.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Dr. Ilfeld is supported by NIH grant GM077026 (Bethesda, MD).

  • The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of this entity.