Plexusblokkades

Plexusblokkades, commonly referred to as plexus blocks, are regional anesthetic techniques used to inhibit nerve transmission in specific peripheral plexus networks. The most frequently employed blocks involve the brachial plexus for upper limb surgery, the lumbar plexus for lower abdominal procedures, and the sacral or pudendal plexus for perineal or pelvic interventions. By depositing local anesthetic around the nerve network, the patient experiences targeted sensory and motor blockade while systemic opioid requirements are reduced.

The procedure is performed under direct visualization, usually with ultrasound guidance, which allows precise needle placement and minimizes the risk of complications. Techniques vary from interscalene, supraclavicular, and infraclavicular approaches for the brachial plexus to transverse processes or psoas compartment approaches for the lumbar plexus. Sedation is often used in addition to spinal or general anesthesia, depending on the extent of the block and patient factors.

Indications for plexusblokkades include prevention of intraoperative pain, reduction of postoperative opioid consumption, and facilitation of early mobilization. Contraindications encompass local infection at the puncture site, coagulopathy, patient refusal, and known allergy to local anesthetics. Potential complications include nerve injury, local anesthetic systemic toxicity, pneumothorax, hematoma, and inadvertent intravascular injection. Careful patient selection, dosage calculation, and use of test doses diminish these risks.

Historically, regional anesthesia developed in the 19th century, with plexus blocks gaining widespread acceptance in the late 20th century due to improvements in imaging and needle technology. Modern guidelines advocate their use as part of multimodal analgesia schemes, contributing to enhanced recovery protocols in various surgical specialties.