Continuous cervical epidural anesthesia in hand surgery

Regional anesthesia, with its known benefits such as increased blood flow, reduced cost, and security, is a method of choice for hand surgery. Recentl y, the authors have switched from axillary block to continuous cervical epi dural anesthesia, which has several advantages such as low cost, a pain-fre e postoperative period, better control of tourniquet pain, and the avoidanc e of a motor block so that early active motion is possible. Continuous cerv ical epidural anesthesia is a safe and reliable method, providing a sensory block with an infusion rate of 4 ml/hr ultracaine (articaine 2 percent), a nd a motor block when the dosage is increased to 8 ml/hr ultracaine (artica ine 2 percent). Postoperatively, only 4 ml/hr ultracaine (articaine 2 perce nt) is sufficient to provide a sensory block. The method provides both good perfusion and a lower local anesthetic drug dosage than axillary block.