Ultrasound-guided supraclavicular brachial plexus block
- PMID: 14570677
- DOI: 10.1213/01.ANE.0000062519.61520.14
Ultrasound-guided supraclavicular brachial plexus block
Abstract
In this study, we evaluated state-of-the-art ultrasound technology for supraclavicular brachial plexus blocks in 40 outpatients. Ultrasound imaging was used to identify the brachial plexus before the block, guide the block needle to reach target nerves, and visualize the pattern of local anesthetic spread. Needle position was further confirmed by nerve stimulation before injection. The block technique we describe aligned the needle path with the ultrasound beam. The block was successful after one attempt in 95% of the cases, with one failure attributable to subcutaneous injection and one to partial intravascular injection. Pneumothorax did not occur. Our preliminary data suggest that a high-resolution ultrasound probe can reliably identify the brachial plexus and its neighboring structures in the supraclavicular region. The technique of real-time guidance during needle advancement can quickly localize nerves. Distinct patterns of local anesthetic spread observed on ultrasound can further confirm accurate needle location.
Implications: Real-time ultrasound imaging during supraclavicular brachial plexus blocks can facilitate nerve localization and needle placement and examine the pattern of local anesthetic spread.
Comment in
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One view is no view.Anesth Analg. 2004 Jun;98(6):1812. doi: 10.1213/01.ANE.0000120089.29979.3E. Anesth Analg. 2004. PMID: 15155358 No abstract available.
References
-
- Moorthy SS, Schmidt SI, Dierdof SF, et al. A supraclavicular lateral approach for brachial plexus regional anesthesia. Anesth Analg 1991; 72: 241–4.
-
- Brown DL, Cahill DR, Bridenbaugh LD. Supraclavicular nerve block: anatomic analysis of a method to prevent pneumothorax. Anesth Analg 1993; 76: 530–4.
-
- Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications—Study Group on Regional Anesthesia. Anesth Analg 1999; 88: 847–52.
-
- Kapral S, Krafft P, Eibenberger K. Ultrasound guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 1994; 78: 507–13.
-
- Yang WT, Chui PT, Metrewelli C. Anatomy of the brachial plexus revealed by sonography and the role of sonographic guidance in anesthesia of the brachial plexus. AJR Am J Roentgenol 1998; 171: 1631–6.
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