BACKGROUND There is some debate about the proper site and arm position and the direction of the needle for the performance of ultrasound guided infraclavicular block. METHODS Using ultrasound, we compared the ease and success rate of a medial or a lateral approach to the brachial plexus for performing infraclavicular block in two groups of patients (n=202). The proximity of the needle to the ...

Dr Nair’s letter to the editor regarding the failed nerve blocks mentioned in our paper, “Comparison of the supraclavicular, infraclavicular and axillary approaches for ultrasound-guided brachial plexus block for surgical anesthesia”,1 raised several points that I believe are worth looking at in more detail. We are grateful for Dr Nair’s comments which have contributed to the furthering of scho...

We present a case of unexpectedly prolonged motor and sensory block following a successful single injection ultrasound - guided infraclavicular block with bupivacaine (0.25%) and dexamethasone (8 mg). ultrasound guidance and safety measurement such as injection of the local anaesthetic at a slow rate and verifying that usual resistance was felt throughout the injection, has been applied. It too...

To the Editor, We read with great interest the recently reported study of Chan et al.1 This study warrants comment due to the low success rates reported after axillary brachial plexus block, despite the authors’ internationally recognized experience with these techniques. The study compared regional anesthesia of the upper limb using an ultrasound-guided (US) approach (the most expensive techni...

OBJECTIVE A successful brachial plexus block requires a large volume of a local anesthetic. Sonography allows reliable deposition of the anesthetic around the cords of the brachial plexus, potentially lowering the anesthetic requirement. METHODS Fifteen sonographically guided infraclavicular blocks were performed in 14 patients with 2% carbonated lidocaine with epinephrine through a 17-gauge ...

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...

BACKGROUND AND OBJECTIVES This study shows how the diffusion of the anesthetic into the sheath occurs through the axillary infraclavicular space and hence proves the efficacy of the anesthetic block of the brachial plexus, and may thereby allow a consolidation of this pathway, with fewer complications, previously attached to the anesthesia. MATERIALS AND METHODS 33 armpits of adult cadavers w...

BACKGROUND Continuous perineural infusion of local anesthetic provides better postoperative analgesia than intravenous administration of opioids or NSAIDs in upper limb surgery. The infraclavicular approach is a good option due to the muscular stability to catheter; the abduction of the arm apparently makes more superficial the brachial plexus and which elevates clavicle cephalad. AIM The aim...