Successful brachial plexus block requires a thorough knowledge of anatomy, both to decide on the appropriate approach and to locate the nerves. The plexus is traditionally found at specific anatomical points by using bony or vascular landmarks, whereas ultrasound allows block of the plexus at any point along its length. The course of the brachial plexus and its relationship to nearby structures...

There are multiple sites at which the brachial plexus block can be induced in selecting regional anesthesia for upper extremity surgical patients. The most frequently used blocks are axillary, infraclavicular, supraclavicular, and interscalene. One must understand brachial plexus anatomy to use these blocks effectively, as well as the practical clinical differences between the blocks. Axillary ...

Brachial plexuses of 110 healthy volunteers were examined using high resolution color Doppler ultrasound. Ultrasonic characteristics and anatomic variation in the intervertebral foramen, interscalene, supraclavicular and infraclavicular, as well as the axillary brachial plexus were investigated. Results confirmed that the normal brachial plexus on cross section exhibited round or elliptic hypoe...

Irritation of neural structures, specifically the brachial plexus outside of the cervical spine is capable of producing pain in the upper extremity. These pain patterns may be similar to pain originating from the cervical spine, presenting a diagnostic challenge. Brachial plexus block is performed at multiple levels, including interscalene, supraclavicular, infraclavicular, and axillary. Inters...

BACKGROUND Magnetic resonance neurography (MRN) is an imaging method by which nerves can be selectively highlighted. Using commercial software, the authors explored a variety of approaches to develop a three-dimensional volume-rendered MRN image of the entire brachial plexus and used it to evaluate the accuracy of infraclavicular block approaches. METHODS With institutional review board appro...

A 23-year-old male British soldier developed a progressive sensory loss and weakness in his right arm during a 12 km training run with a load of approximately 70 kg. There was no recovery of his symptoms within 3 months and both MRI and USS did not demonstrate a site of compression within the brachial plexus. An infraclavicular brachial plexus exploration was performed 11 months after injury th...

BACKGROUND Current techniques of brachial plexus block are "blind," and nerve localization can be frustrating and time consuming. Previous studies on ultrasound-assisted brachial plexus blocks are mostly performed with scanning probes of 10 MHz or less. The authors tested the usefulness of a state-of-the-art, high-resolution ultrasound probe (up to 12 MHz) in identifying the brachial plexus in ...