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narasimha reddy
narasimha reddy
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BRACHIAL PLEXUS BLOCK A REVIEW Dr.P.NARASIMHA REDDY M.D D.A PROFESSOR & H.O.D DEPT. OF ANAESTHESIOLOGY KURNOOL MEDICAL COLLEGE KURNOOL
Brachial plexus- a review ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object]
HISTORY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object]
APPLIED ANATOMY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object]
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object]
 
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object]
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Applied Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Choice of approach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Approaches to brachial plexus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INTERSCALENE BLOCK
Approaches- contd. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
SUPRACLAVICULAR BLOCK
Approaches contd . ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CONTINOUS INTERSCALENE BLOCK
Approaches contd . ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INFRACLAVICULAR BLOCK
INFRACLAVICULAR BLOCK
Approaches contd . ,[object Object],[object Object],[object Object],[object Object],[object Object]
AXILLARY BLOCK
Approaches contd . ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TECHNIQUES FOR BP BLOCK ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont .. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TRANSARTERIAL TECHNIQUE AXILLARY BLOCK
Techniques Cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont ….. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont….. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Techniques Cont ….. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SOME GUIDING PRINCIPLES FOR BP BLOCK ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Guiding principles cont….. ,[object Object],2-4 0.25-0.5 8-10 Ropivacaine 2-3 0.25-0.5 8-12 Bupivacaine 7mg with adrenaline 0.5-1 4-7 Lidocaine Dose (mg / kg) Concentr-- ation (%) Duration (hrs) Drugs
Guiding principles cont…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Guiding principles cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Guiding principles cont …. ,[object Object],[object Object],[object Object],[object Object]
COMPLICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications cont … ,[object Object],[object Object],[object Object],[object Object]
Complications cont …. ,[object Object],Needle or catheter trauma, vasoconstrictors, perineural edema, LA toxicity Anaesthesia factors Surgical trauma, strech of nerves, tourniquet ischemia, vascular compromise, peri op. imflamation, post op. infection, hematoma, cast compression, pt. position Surgical factors Preexisting neurological disorders Male, old age,extemes of body habitus, DM Patient factors Pre op. risk factors Categories
Complications cont …. ,[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications cont…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],complications
Complication cont …. ,[object Object],[object Object],[object Object]
Complications cont … ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications . ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications cont … ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications cont …. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THANK Q

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