In recent years, brachial plexus anesthesia techniques for upper limb surgery have been used more and more commonly on children; however, the patient is typically under deep sedation or general anesthesia. For eligible, cooperative children, surgery can also be performed using regional blocks while the patient is awake. We present 5 cases in which Ultrasound (US)-guided infraclavicular brachial...

Bilateral brachial plexus blocks and regional anesthesia in trauma patients are rarely performed due to potential complications when using these techniques. We illustrate a case in which bilateral infraclavicular nerve blocks were placed as part of a multimodal approach to pain management in a trauma patient. We discuss potential hazards, important considerations, and rationale for attempting t...

OBJECTIVE The purpose was to identify the prevalence, causative factors, injury types, and associated injury patterns in multitrauma patients who sustained brachial plexus injuries. METHODS A retrospective review of a prospectively collected and computerized database and a chart review were performed. RESULTS Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting ...

OBJECTIVES Using a through-the-needle local anesthetic bolus technique, ultrasound-guided infraclavicular perineural catheters have been shown to provide greater analgesia compared to supraclavicular catheters. A through-the-catheter bolus technique, which arguably "tests" the anesthetic efficacy of the catheter before initiating an infusion, has been validated for infraclavicular catheters but...

UNLABELLED A new infraclavicular brachial plexus block method has the patient supine with an adducted arm. The target is any of the three cords behind the pectoralis minor muscle. The point of needle insertion is the intersection between the clavicle and the coracoid process. The needle is advanced 0 degrees -30 degrees posterior, always strictly in the sagittal plane next to the coracoid proce...

BACKGROUND Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypot...

OBJECTIVE To reduce the onset of 0.5% bupivacaine by adding 2% lidocaine with 0.5% bupivacaine for ultrasound-guided and double stimulation technique at musculocutaneous and radial nerve for infraclavicular brachial plexus block. DESIGN Prospective randomized double-blinded, controlled trial study. MATERIAL AND METHOD 90 patients undergoing creation of arteriovenous fistula under ultrasound...

Editor’s key points † The hypothesis tested was that the addition of distal nerve blocks to an infraclavicular block would speed up onset. † Infraclavicular block with or without distal blocks of the median, ulnar, and radial nerves were compared using the same total dose of local anaesthetic. † A more rapid onset and more consistent block occurred in the combined group. Background. This prospe...

Interscalene block is used for shoulder surgeries however it almost always results in phrenic nerve palsy1,2. Some anaesthesiologists have described careful ultrasound guided low volume (5mls only) of local anesthetic interscalene which does not cause hemidiaphragmatic paresis3. However we present to you a case where implied recently technique sparing involving combination oblique infraclavicul...