Ultrasound Imaging Aids Infraclavicular Brachial Plexus Block

Abstract

Infraclavicular approach to brachial plexus provides adequate anesthesia of the entire arm. Locall anesthetics can be deposited over cords and brnches of brachiall plexus above the formation of musculocutaneous and axillary nerves. The approach can also easily block ulnar segment of medial cord and intercostobrachial nerve,which helps preventing tourniquet pain. However,distance to the plexus is deeper than the other approaches so that current blind method using anatomical landmarks requires anesthesiologists' delicate manipulation and experience. Through ultrasonoraphy,the location of subclavian artery,as an anatomical landmarks,can be easily identified. It is then very easy and safe to perform infraclavicular brachial plexus block. Our new method showed 89%(n=9)successful rate. The time for the block was 4.2±1.5 min and there was an average of 3.2±0.6 needle penetrations. Thirty three percent(n=3) had subclavian artery been punctured without formation of hematoma clinically. No patient had clinical postoperative pneumothorax.