Surgical anesthesia for proximal arm surgery in the awake patient.

This education article discusses a combination of brachial plexus and peripheral nerve blocks aimed at providing complete surgical anesthesia to the proximal arm, while consistently avoiding diaphragmatic paresis. This type of approach may be warranted in patients with respiratory compromise of any etiology. In these settings awake surgery is recommended to preserve respiratory function and at the same time minimize the risk of infection of the healthcare team by avoiding the aerosol-generating medical procedures associated with general anesthesia. © American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.