Hadzic's Regional Anesthesia > Part II. Foundations of Regional Anesthesia > Section One. Anatomy & Electrophysiology > Chapter 3. Functional Regional Anesthesia Anatomy Faruk Dilberovic, MD, Eldan Kapur, MD, Chi Wong, MS, Admir Hadzic, MD

Functional Regional Anesthesia Anatomy: Introduction

"It is often said that the practice of regional anesthesia is the practice of applied anatomy. Indeed, the practice of regional anesthesia is inconceivable without a sound knowledge of the basic anatomic facts that pertain to the individual anesthesia techniques. However, just as surgeons rely on surgical anatomy or pathologists rely on pathologic anatomy, the anatomic information necessary for the practice of regional anesthesia must be specific to this application. In the past, many new nerve block techniques and "me-too" approaches were devised by academicians merely relying on idealized anatomic diagrams and schematics, rather then on functional anatomy. Ultimately, many of these techniques have only introduced unnecessary confusion in the field and been of negligible relevance to clinical practice. Indeed, once the anatomic layers and tissues sheets are dissected, the fully exposed nerve structures are almost irrelevant to the practice of regional anesthesia. This is because accurate placement of the needle and the spread of the local anesthetic after an injection depends on the interplay between neurologic structures and the neighboring tissues where local anesthetic pools and accumulates, rather than on the mere anatomic organization of the nerves and plexuses. However, much research by regional anesthesiologists has been done in the past 10–15 years on this subject, and many myths of the past have been dispelled. The reader should note that specific anatomic discussions pertaining to individual regional anesthesia techniques are detailed..."