Infraclavicular brachial plexus block

BACKGROUND: The costoclavicular space serves as an alternative approach to the infraclavicular brachial plexus block, and numerous studies in adults have demonstrated promising outcomes for distal upper limb surgery. Blocking the brachial plexus at this level is potentially advantageous because the cords are relatively superficial, located in close proximity to each other and easily identified using ultrasound. AIMS: This study aimed to assess the success rate and feasibility of costoclavicular block in children undergoing unilateral below elbow upper limb surgery...

Background and aim The regional anesthesia technique is commonly used for upper extremity surgery as an alternative to general anesthesia. The study aimed to compare the efficacy of infraclavicular brachial plexus block (BPB) and a combination of infraclavicular brachial plexus block with suprascapular nerve block for postoperative analgesia in patients undergoing shoulder surgeries. Method A total of 62 patients of both sexes with the American Society of Anaesthesiologists (ASA) physical status I/II/III, aged between 18 and 65 years, and undergoing shoulder surgery, were included in this prospective, single-blinded, randomized controlled trial...

BACKGROUND AND AIMS: Costoclavicular brachial plexus block is gaining popularity due to its ease of application. Lateral and medial costoclavicular approaches have recently been defined. In the current study, we aimed to investigate the procedural execution of these approaches in the pediatric population. METHODS: In this study 55 children aged between 2 and 10 years were randomized to receive lateral (LC group) or medial (MC group) costoclavicular brachial plexus block after induction of general anesthesia for postoperative analgesia...

The retroclavicular approach to the infraclavicular region (RAPTIR) is a recently described locoregional technique for upper limb analgesia that offers advantages over the classic infraclavicular block. RAPTIR is considered an effective and easy-to-perform block associated with few complications and better patient comfort. We present a case of a critically ill patient with thoracic and upper limb trauma. Despite multimodal analgesia, the patient developed delirium and experienced suboptimal pain control...

BACKGROUND: The gold standard postoperative analgesia protocol for arthroscopic rotator cuff repair procedures is the interscalene block (ISB), which prevents the significant consequences of phrenic nerve block associated with hemidiaphragmatic paralysis (HDP). The infraclavicular brachial plexus block (BPB) combined with the suprascapular nerve block (SSNB) had the same analgesic efficacy as the infraclavicular BPB alone, with no effect on respiration. OBJECTIVES: Therefore, the study aimed to assess the HDP and analgesic efficacy of both approaches in controlling pain following arthroscopic rotator cuff repair surgeries...

BACKGROUND: Regional anaesthesia offers the anaesthesiologist, the surgeon, as well as the patient advantages over general anaesthesia such as being conscious through the surgery, avoiding multiple drugs, better haemodynamic stability, excellent postoperative analgesia, and faster per oral consumption post surgery. Compared with the axillary approach, the brachial plexus block at the level of the clavicle can anaesthetize all four distal upper extremity nerve territories without the requirement for a separate block of the musculocutaneous nerve...

BACKGROUND: Programmed intermittent bolus (PIB) is a novel method of intermittent drug delivery commonly employed in labor epidural analgesia. This study aimed to evaluate the potential benefits of PIB over continuous infusion (CI) for postoperative analgesia following upper limb surgeries distal to the mid-humerus level using ultrasound-guided infraclavicular brachial plexus block (USG-IBPB). METHODS: The USG-IBPB was performed on a total of 30 patients scheduled for upper limb surgery distal to the mid-humerus level...

The effects of oral dexamethasone on peripheral nerve blocks have not been investigated. We randomly allocated adults scheduled for forearm or hand surgery to oral placebo (n = 61), dexamethasone 12 mg (n = 61) or dexamethasone 24 mg (n = 57) about 45 min before lateral infraclavicular block. Mean (SD) time until first pain after block were: 841 (327) min; 1171 (318) min; and 1256 (395) min, respectively. Mean (98.3%CI) differences in time until first postoperative pain for dexamethasone 24 mg vs...

BACKGROUND: Regional anesthesia for an upper limb provides many advantages over general anesthesia, especially in orthopedic surgery. OBJECTIVES: This trial aimed to compare a retroclavicular approach to the infraclavicular brachial plexus with a costoclavicular approach in term of needle time, image time, and procedure time, and comparing both with the classic technique for upper limb surgeries guided by ultrasound. STUDY DESIGN: Prospective, randomized, single-blinded controlled trial...

BACKGROUND: The costoclavicular approach to brachial plexus block may have a more favorable anatomy than the classic infraclavicular approach. However, there are conflicting results in the literature regarding the comparative effectiveness of these two techniques. METHODS: We systematically searched for Randomized Controlled Trials (RCTs) comparing costoclavicular with infraclavicular brachial plexus blocks for upper extremity surgeries on MEDLINE, EMBASE, and Ovid...

Peripheral nerve blocks are an increasingly common method of providing postoperative analgesia for shoulder surgeries. However, the standard technique, the interscalene block (ISB), inevitably causes hemidiaphragmatic paresis (HDP), secondary to phrenic nerve palsy. This can cause morbidity in patients with preexisting respiratory compromise, prompting investigation into alternative "phrenic-sparing" nerve blocks. The aim of this review was to give an overview of these blocks and critically evaluate the current literature to determine if any are suitable replacements for ISB...

PURPOSE: Ultrasound-guided brachial plexus block (UGBPB) has interscalene, supraclavicular, infraclavicular, and axillary approaches. The axillary block is considered to be the safest and with fewer adverse events compared to the interscalene (eg, phrenic nerve block, spinal cord or vertebral artery puncture) and supraclavicular (eg, pneumothorax). However, with regard to postoperative neurological symptoms (PONS), it is controversial whether its incidence after an axillary block was higher than that after non-axillary approaches"...

The supraclavicular block (SCB) and the infraclavicular block (ICB) are introduced to meet upper extremity surgery, where the transducer or the insertion point is placed superiorly and inferiorly at the approximate midpoint of the clavicle, respectively. These two approaches are highly appealing since they clearly exhibited each cord and its associated anatomy. In addition, it directed the needle accurately with real-time imaging by ultrasound guidance. Therefore, it brought higher success rates and fewer complications...

Background The clinical utility of adjuvants with local anesthesia produces an excellent nerve block with prolonged duration and faster onset. Brachial plexus block is widely used nowadays in patients undergoing upper limb surgery There are several approaches to achieve brachial plexus block such as interscalene, supraclavicular, infraclavicular, and axillary. The objective of this study is to compare the effectiveness of dexamethasone to dexmedetomidine as adjuvants to bupivacaine in patients undergoing ultrasound-guided infraclavicular brachial plexus (USG-ICBP) block...

BACKGROUND AND AIMS: The most effective approach for infraclavicular brachial plexus block in adults is to target the posterior cord, usually situated posterior to axillary artery. However, we do not know if this can be extrapolated in children. Our primary objective was to compare the clinical success rate of ultrasound guided infraclavicular brachial plexus block in children with local anesthetic injection aimed at two targets. These were posterior to axillary artery (posterior cord) and lateral to axillary artery (lateral cord)...

BACKGROUND: The intercostobrachial nerve blockade is required, in addition to brachial plexus block, to anesthetize the entire upper arm. No studies have described the use of erector spinae plane (ESP) block for an intercostobrachial nerve block. CASE PRESENTATION: A 72-year-old man was scheduled to undergo left brachial vein transposition-arteriovenous fistula creation for hemodialysis access. An ultrasound-guided infraclavicular brachial plexus block was performed using a mixture of 0...

In recent years, ultrasound-guided costoclavicular brachial plexus block (CCB) has gained attention as a novel approach for brachial plexus nerve block. Human anatomy studies have identified the costoclavicular space as the area between the midpoint of the clavicle and the first rib. This space accommodates the brachial plexus, axillary arteries, and veins. Its superficial and fixed position makes it a promising option for infraclavicular brachial plexus blockage, providing a safe and reliable analgesic effect...

INTRODUCTION: The ultrasound-guided infraclavicular brachial plexus block by triple-point injection method was aimed at blocking the three individual cords in the infraclavicular region. Recently, a single-point injection method which does not require visualization of cords to produce nerve block has been introduced. This study compared the block onset time, performance time, patient's satisfaction, and complications between the ultrasound guided triple-point injection and single-point injection methods...

BACKGROUND: Both local anesthesia (LA) and brachial plexus (BP) anesthesia are commonly used in hand surgery. LA has increased efficiency and reduced costs but BP is often favoured for more complex hand surgeries despite requiring greater time and resources. The primary study objective was to assess the quality of recovery of patients who receive LA or BP for hand surgery. Secondary objectives were to compare post-operative pain and opioid use. METHODS: This prospective, randomized, controlled, non-inferiority study enrolled patients undergoing surgery distal to the carpal bones...

Painful end-stage wrist osteoarthritis (OA) unresponsive to conservative treatment is frequently managed with total wrist arthrodesis (TWA), which might render pain alleviation and ameliorate function, pain, and grip strength. Usual indications for TWA include inflammatory arthritis, idiopathic degenerative OA and posttraumatic OA, Kienböck's illness, brachial plexus palsy, cerebral paralysis, infraclavicular brachial plexus blocks and other spastic and contracture base illnesses, scapholunate advanced collapse, scaphoid nonunion advanced collapse, and failure of other surgical techniques such as after failed total wrist arthroplasty, four-corner fusion, proximal row carpectomy and severe ligament injuries (this procedure is carried out when all other treatment alternatives have failed to control the individual's symptoms)...