Regional Anesthesia Techniques for Upper Limb Surgery
Summary
The evolution of regional anesthesia for upper limb surgery has been driven by the pursuit of targeted analgesia, reduced systemic side-effects and enhanced postoperative recovery. Techniques such as brachial plexus blocks—supraclavicular, infraclavicular, interscalene and axillary approaches—offer segmental blockade of sensory and motor fibres to the shoulder, arm, forearm and hand. Ultrasound guidance and adjunct pharmacological agents have refined block accuracy, onset time and duration while minimising complications. Fascial plane blocks, including clavipectoral and pectoral plexus blocks, extend the analgesic repertoire by selectively targeting peri-clavicular and chest wall innervation for clavicle and proximal humerus procedures. Advances in choice and concentration of local anaesthetics, incorporation of adjuvants such as dexamethasone, and real-time imaging techniques have converged to optimise block efficacy and safety. These developments underpin a patient-centred approach, enabling outpatient care models, reducing opioid consumption and improving functional recovery through effective perioperative analgesia.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Regional Anesthesia Techniques for Upper Limb Surgery publication trend
The graph below shows the total number of articles in regional anesthesia techniques for upper limb surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Brachial plexus block: Regional blockade of the brachial plexus nerves to provide anaesthesia for shoulder, arm, forearm and hand surgery.
Ultrasound guidance: Real-time sonographic imaging used to visualise anatomy and guide needle placement for regional nerve blocks.
Rebound pain: A transient increase in pain intensity that may occur after the resolution of a nerve block.
Local anaesthetic: A pharmacological agent, such as ropivacaine, that inhibits nerve conduction to produce reversible loss of sensation.
Fascial plane block: Regional anesthesia technique involving injection of local anaesthetic into an anatomical fascial plane to block sensory nerve branches.
References
- Optimal concentration of ropivacaine for brachial plexus blocks in adult patients undergoing upper limb surgeries: a systematic review and meta-analysis. Frontiers in Pharmacology (2023).
- The effect of perineural dexamethasone on rebound pain after ropivacaine single-injection nerve block: a randomized controlled trial. BMC Anesthesiology (2021).
- Ultrasound-Guided Clavipectoral Fascial Plane Block for Surgery Involving the Clavicle: A Case Series. Cureus (2020).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.