Regional anesthesia for upper extremity surgery is close to the ideal match for anesthetic and surgical procedure for patient, anesthesiologist, surgeon, and hospital administrator. For the patient having upper extremity surgery, regional anesthesia can provide a combination of minimal systemic impairment and excellent localized postoperative analgesia. For the anesthesiologist, the anatomy of the upper extremity is well suited for local anesthetic blockade because a single, accessible plexus of nerves associated with reliable landmarks innervates the entire arm. For the surgeon, regional anesthesia allows dense anesthesia completely isolated to the peripheral site of the surgery (Figure 1). For the hospital administrator, regional anesthesia minimizes costs<sup>8 Chilvers C.R., Kinahan A., Vaghadia H. , et al. Pharmacoeconomics of intravenous regional anesthesia versus general anesthesia for outpatient hand surgery Can J Anaesth 1997 ;  44 : 1152-1156  [cross-ref]

Cliquez ici pour aller à la section Références</sup> because conduct of the anesthetic itself generates little cost, and operating room (OR) time can be reduced by placing the block preoperatively, whereas recovery from the anesthetic facilitates early ambulatory patient discharge<sup>11 D’Alessio J.G., Rosenblum M., Shea K.P. , et al. A retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy Reg Anesth 1995 ;  20 : 62-68

Cliquez ici pour aller à la section Références</sup> (see article by R. Greengrass elsewhere in this issue). Realizing these benefits requires a working knowledge of upper extremity anatomy as well as a host of methods useful in decreasing block latency, the means to increase block duration appropriately, and a familiarity with the common approaches and techniques useful for regional anesthesia of the upper extremity.