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Anesthesia
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==== Nerve blocks ==== {{Further|Nerve block}} When [[local anesthetic]] is injected around a larger diameter nerve that transmits sensation from an entire region it is referred to as a [[nerve block]] or regional nerve blockade. Nerve blocks are commonly used in dentistry, when the [[mandibular nerve]] is blocked for procedures on the lower teeth. With larger diameter nerves (such as the [[scalene muscles|interscalene]] block for upper limbs or [[Psoas major muscle|psoas compartment]] block for lower limbs) the nerve and position of the needle is localized with [[Medical ultrasonography|ultrasound]] or electrical stimulation. Evidence supports the use of ultrasound guidance alone, or in combination with peripheral nerve stimulation, as superior for improved sensory and motor block, a reduction in the need for supplementation and fewer complications.<ref>{{cite journal |last1=Lewis |first1=Sharon R |last2=Price |first2=Anastasia |last3=Walker |first3=Kevin J |last4=McGrattan |first4=Ken |last5=Smith |first5=Andrew F |title=Ultrasound guidance for upper and lower limb blocks |journal=Cochrane Database of Systematic Reviews |date=11 September 2015 |volume=2015 |issue=9 |pages=CD006459 |doi=10.1002/14651858.CD006459.pub3 |pmid=26361135 |pmc=6465072 }}</ref> Because of the large amount of local anesthetic required to affect the nerve, the maximum dose of local anesthetic has to be considered. Nerve blocks are also used as a continuous infusion, following major surgery such as knee, hip and shoulder replacement surgery, and may be associated with lower complications.<ref name="Ullah">{{cite journal | vauthors = Ullah H, Samad K, Khan FA | title = Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD007080 | date = February 2014 | volume = 2014 | pmid = 24492959 | pmc = 7182311 | doi = 10.1002/14651858.CD007080.pub2 }}</ref> Nerve blocks are also associated with a lower risk of neurologic complications compared to the more central epidural or spinal neuraxial blocks.<ref name="Miller 2010" />{{rp|1639β41}}
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