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Supraclavicular Block

Anatomy

The brachial plexus is located lateral and superficial to the subclavian artery at the supraclavicular level and is identified as a cluster of hypoechoic round structures often described as a bunch of grapes. The subclavian artery is located at the midpoint of the clavicle. The first rib is identified deep to the subclavian artery and appears as a hyperechoic mostly linear structure by ultrasound exam. The parietal pleura may be identified lateral and medial to the first rib (image 2).m a paragraph. Click here to add your own text and edit me. It's easy.

Block Procedure

The supraclavicular block is performed with the patient supine and back slightly elevated. The head is turned away from the block site to allow the ultrasound to be manipulated supraclavicularly. The ultrasound probe is positioned above the clavicle in a parallel orientation to the clavicle. The subclalvian artery is identified near the midpoint of the clavicle by ultrasound. The brachial plexus will be identified lateral and superficial to the subclavian artery. The block needle is inserted laterally to the ultrasound probe using the enplane approach (image 1). Care should be taken to ensure the block needle remains superficial to the first rib and parietal pleura (image 2). This is accomplished by maintaining constant visualization of the block needle throughout the procedure. Local anesthetic is delivered lateral and superficial to the brachial plexus. Adequate spread of local anesthetic should be visualized by ultrasound guidance. Local anesthetic is injected only after careful aspiration to avoid an inadvertent intravascular injection.

Image 1

Image 2

Every effort has been made to ensure the accuracy of the information presented within this website. The information presented does not constitute medical advice.