Close‐to‐the‐nerve vs interfascial plane blocks: Sniper rifle vs shotgun—which will hit the target most reliably?

Soon after the discovery of local anesthetics (LA), the practice and art of regional anesthesia rapidly developed. One early issue to solve was how best to place the LA close to the nerve/nerves of interest. With regards to the brachial plexus the first ever brachial plexus block reported in 1885 is attributed to Halstead who following local infiltration surgically exposed the plexus at its supraclavicular location and then under direct vision instilled LA onto the plexus (1). This obviously provided excellent precision combined with an almost maximal success rate but overall it was a cumbersome technique to allow high precision deposition of the LA at the appropriate nerve structures. This article is protected by copyright. All rights reserved.