Spinal anesthesia and infraclavicular brachial plexus block for upper extremity reconstruction requiring grafting

Combined use of upper limb blocks in the same surgery with lower limb central blocks is rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in such surgeries. However, the use of ultrasound provides reliable anesthetic accumulation around the nerves, thereby reducing the need for local anesthetics, furthermore local anesthetic is used in spinal anesthesia compared to epidural anesthesia is much less.