Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 5 1 2018 12 29 22 29 EN Zahid Khan Professor of Anesthesiology and Critical Care, Deputy for Research, Department of Anesthesiology and Critical Care, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran. Hamid Reza Amiri Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Amjed Mohammed Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2017 08 03 2018 07 04 Regional anesthesia is an expanding subspecialty and is gaining increasing popularity due to its significant benefits over general anesthesia if appropriately accomplished, which includes superior intraoperative pain control, attenuation of the surgical stress response, minimal systemic impairment, lower incidence of postoperative nausea and vomiting, excellent localized postoperative analgesia, and decreased hospital cost and stay. Needle conduction guide toward the targets always has a great importance. The most commonly used local anesthetics include lidocaine, ropivacaine, bupivacaine, and mepivacaine. The type of local anesthetic, the concentration, the volume administered, and the location of the block will affect the onset, duration and depth /type of block. Due to ineffectivity of neuraxial block in upper limbs, upper extremity blocks may be considered as the sole substitute or supersede method of anesthesia for upper limb surgeries. https://aacc.tums.ac.ir/index.php/aacc/article/view/144 https://aacc.tums.ac.ir/index.php/aacc/article/download/144/403