Evaluation of brachial plexus fascicles involvement on infraclavicular block: unfixed cadaver study

Gusmão, Luiz Carlos Buarque de; Lima, Jacqueline Silva Brito; Ramalho, Jeane da Rosa Oiticica; Leite, Amanda Lira dos Santos; Silva, Alberson Maylson Ramos da

doi:10.1016/j.bjane.2014.06.010

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…1 Later, in 1917, Bazy et al further described the infraclavicular approach by inserting a needle below the clavicle, in an 'anaesthetic line' drawn between the anterior tubercle of the sixth cervical vertebra and the coracoid process. 2,3 In the following years, various authors substantiated this technique and confirmed Bazy's findings. 4,5 In 1973, Raj et al introduced a new technique of inserting the needle at the midpoint of the clavicle, directing the tip laterally to prevent puncturing the chest wall.…”

Section: Introductionmentioning

confidence: 57%

A review of the anatomy and a step-by-step visual guide to performing an ultrasound-guided infraclavicular brachial plexus block

Govender

Möhr

Tshabalala

et al. 2020

Southern African Journal of Anaesthesia and Analgesia

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Background: The aim of this description is to provide step-by-step guidelines for performing an ultrasound guided infraclavicular brachial plexus nerve block. Methods: The brachial plexus in the infraclavicular fossa of sixty healthy volunteers was scanned in the horizontal/transverse plane. The relevant regional anatomy was studied to identify the muscular and vascular structures seen on the ultrasound screen. Results: The entire process was documented and a standard, step-by-step guide to performing ultrasound guided vertical infraclavicular brachial plexus blocks was developed. Conclusion: The development of high-resolution ultrasound guidance has allowed for the direct visualisation of the brachial plexus when performing nerve blocks. Ultrasound-guided infraclavicular brachial plexus nerve blocks are becoming more popular. This description aimed to provide step-by-step guidelines on how to perform this block safely and efficiently.

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Section: Introductionmentioning

confidence: 57%

A review of the anatomy and a step-by-step visual guide to performing an ultrasound-guided infraclavicular brachial plexus block

Govender

Möhr

Tshabalala

et al. 2020

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

show abstract

“…The infraclavicular (ICB) (coracoid) approach for brachial plexus anesthesia is recognized for its facility and simplicity to perform. However, an inevitable pitfall of this method is the steep angle between the needle and the ultrasound probe that makes needle visibility challenging (3)(4)(5)(6)(7)(8). Because of its different needle entry point, the retroclavicular (RCB) approach (9) offers an almost perpendicular needle-ultrasound (US) beam angle, but aims at the same goal as the ICB.…”

Section: Introductionmentioning

confidence: 99%

Retroclavicular vs Infraclavicular block For Brachial Plexus Anesthesia: A Multi-Centric Randomized Trial

Blanco

Laferrière-Langlois

Jessop

et al. 2019

Preprint

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Background: The coracoid approach is a simple method to perform ultrasound-guided brachial plexus regional anesthesia (RA) but its simplicity is counterbalanced by a difficult needle visualization. We hypothesized that the retroclavicular (RCB) approach is not longer to perform when compared to the coracoid (ICB) approach, and improves needle visualization. Methods: This randomized, controlled, non-inferiority trial conducted in two hospitals, included patients undergoing distal upper limb surgery. Patients were randomly assigned to a brachial plexus block (ICB or RCB). The primary outcome was performance time (sum of visualization and needling time), and was analyzed with a non-inferiority test of averages. Depth of sensory and motor blockade, surgical success, total anesthesia time, needle visualization, number of needle passes and complications were also evaluated. Subgroup analysis restricted to patients with higher body mass index was completed. Results: We included 109 patients between September 2016 and May 2017. Mean RCB performance time was 4.8 ± 2.0 min while ICB was 5.2 ± 2.3 min (p=0.06) with a 95% CI reaching up to 5.8% longer. RCB conferred an ultrasound-needle angle closer to 0° and significantly improved needle visibility after the clavicle was cleared and before local anesthetic administration. No differences were found in the secondary outcomes. Similar results were found in the subgroup analysis. Conclusion: RCB approach for brachial plexus anesthesia was similar to ICB approach in terms of time performance. Needle visibility, which represent an important clinical variable, was superior and angle between needle and ultrasound probe was close to 0° in the RCB group. Clinical Trial Registration: ClinicalTrials.gov (NCT02913625), registered 26 September 2016.

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“…The infraclavicular (ICB) (coracoid) approach for brachial plexus anesthesia is recognized for its facility and simplicity to perform. However, an inevitable pitfall of this method is the steep angle between the needle and the ultrasound probe that makes needle visibility challenging (3)(4)(5)(6)(7)(8). Because of its different needle entry point, the retroclavicular (RCB) approach ( 9) offers an almost perpendicular needle-ultrasound (US) beam angle, but aims at the same goal as the ICB.…”

Section: Introductionmentioning

confidence: 99%

Retroclavicular vs Infraclavicular block For Upper Limb Anesthesia: A Multi-Centric Randomized Trial

Afg

Laferrière-Langlois

Jessop

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The coracoid approach is a simple method to perform ultrasound-guided brachial plexus regional anesthesia (RA) but its simplicity is counterbalanced by a difficult needle visualization. We hypothesized that the retroclavicular (RCB) approach is not longer to perform when compared to the coracoid (ICB) approach, and improves needle visualization. Methods: This randomized, controlled, non-inferiority trail conducted in two hospitals, included patients undergoing distal upper limb surgery. Patients were randomly assigned to a brachial plexus block (ICB or RCB). The primary outcome was performance time (sum of visualization and needling time), and was analyzed with a non-inferiority test of averages. Depth of sensory and motor blockade, surgical success, total anesthesia time, needle visualization, number of needle passes and complications were also evaluated. Subgroup analysis restricted to patients with higher body mass index was completed. Results: We included 109 patients between September 2016 and May 2017. Mean RCB performance time was 7.1% shorter than ICB (retro: 4.8 ± 2.0 min; infra: 5.2 ± 2.3 min, p=0.06) with a 95% CI reaching up to 5.8% longer. RCB conferred an ultrasound-needle angle closer to 0° and significantly improved needle visibility after the clavicle was cleared and before local anesthetic administration. No differences were found in the secondary outcomes. Similar results were found in the subgroup analysis. Conclusion: In patients undergoing distal upper limb surgery with an infraclavicular anesthesia, performance time with RCB approach was deemed clinically similar to ICB approach while improving needle visibility. Clinical Trial Registration: ClinicalTrials.gov (NCT02913625), registered 26 September 2016

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Evaluation of brachial plexus fascicles involvement on infraclavicular block: unfixed cadaver study

Cited by 5 publications

References 7 publications

A review of the anatomy and a step-by-step visual guide to performing an ultrasound-guided infraclavicular brachial plexus block

A review of the anatomy and a step-by-step visual guide to performing an ultrasound-guided infraclavicular brachial plexus block

Retroclavicular vs Infraclavicular block For Brachial Plexus Anesthesia: A Multi-Centric Randomized Trial

Retroclavicular vs Infraclavicular block For Upper Limb Anesthesia: A Multi-Centric Randomized Trial

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