الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
Both axillary brachial plexus block (ABPB) and general anesthesia (GA) have been extensively employed in upper limb surgery. ABPB is one of the most popular and widely used techniques for brachial plexus blocks and the most commonly used techniques to achieve upper limb regional anesthesia. General anesthesia (GA) has been used successfully for surgery of the upper extremities. It has faster induction time; but unfortunately, it might be associated with several undesirable side effects including postoperative pain, postoperative nausea and vomiting, delayed discharge from hospital and postoperative sleep disturbances. Axillary brachial plexus block is an alternative method for anesthesia of the upper extremity. It associated with decrease incidence of postoperative pain and postoperative nausea and vomiting, also the use of regional anesthesia is associated with economic benefits to the heath care facility and improved patient satisfaction). Sleep deprivation is a major problem in surgical patients having a deleterious effect on postoperative recovery, many Factors implicated in postoperative sleep disturbances among them is the severity of the surgical procedure, and the neuroendocrine response to surgery and postoperative pain which mostly needs opioids to control it. Unfortunately opioid analgesia worsens postoperative sleep by decreasing slow-wave sleep (SWS), also cause dose-dependent REM suppression, and arousals during sleep through exerting control over various biological systems). Postoperative sleep disturbances are not only one of the manifestations of postoperative brain dysfunction, but also can induce postoperative fatigue, metabolic disorders, hypertension, cerebrovascular, and cardiovascular disease. So it has been suggested that use of peripheral nerve blocks may have some potential benefits in overcoming these problems. It was believed that Axillary brachial plexus block plays an important role in relieving sleep disturbances after surgery, as it decrease postoperative central apnea index also decrease postoperative opioid consumption so ultrasound- guided axillary brachial plexus block provides satisfactory anesthesia and excellent analgesia and better postoperative sleep outcome after hand surgery when compared to general anesthesia.
CONCLUSION
Ultrasound-guided axillary brachial plexus block provided satisfactory anesthesia and superior analgesia and better post-operative sleep outcome after hand surgery when compared to general anesthesia .