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. 2019 Oct 7;7(11):2279-2280.
doi: 10.1002/ccr3.2467. eCollection 2019 Nov.

Cervical ribs-An anatomical obstacle for upper limb regional blocks

Enrique Moreno  1 , Dan Sebastian Dirzu  2 , María Fernanda Bastías Moraga  1 , Mario Fajardo Pérez  3
Affiliations

Cervical ribs-An anatomical obstacle for upper limb regional blocks

Enrique Moreno et al. Clin Case Rep. .

Abstract

Anatomic variations of the cervical and supraclavicular regions are possible with an impact on regional anesthesia strategy. The presence of cervical ribs may obstruct needle visualization for brachial plexus block in those regions. Preprocedural scan may help in choosing the appropriate technique.

Keywords: brachial plexus; cervical ribs; supraclavicular block; ultrasound‐guided regional anesthesia.

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Conflict of interest statement

EM, MFB, and MFP have no conflict of interest to disclose related with this paper. DSD is also senior editor of the clinical image section for the Clinical Case Reports journal.

Figures

Figure 1
Figure 1
Supraclavicular approach of brachial plexus. A, The ultrasound image of the supraclavicular space. B, The same picture with labels of the anatomical structures AA, subclavian artery
Figure 2
Figure 2
Interscalene approach of brachial plexus. A, The ultrasound of the interscalene space. B, The same picture with labels of the anatomical structures
Figure 3
Figure 3
AP X‐ray, yellow arrows show the cervical ribs
See this image and copyright information in PMC

References

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    1. Watanabe T, Yanabashi K, Moriya K, Maki Y. Tsubokawa, Baba, Ultrasound‐guided supraclavicular brachial plexus block in a patient with a cervical rib. Can J Anesth. 2015;62:671‐673. - PubMed

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