Eight Ball, Corner Pocket for Ultrasound-Guided Supraclavicular Block: High Risk for a Scratch

Samet, Ron E.; Villamater, Edwin

doi:10.1016/j.rapm.2007.01.009

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…The "corner pocket" supraclavicular block approach may present with a potential risk of pneumothorax due to the proximity of the needle tip and pleura [19]. In our study, there were no serious complications, and, in particular, no pneumothoraxes with the "corner pocket" approach.…”

Section: Discussionsupporting

confidence: 41%

Comparison of Supraclavicular Regional Nerve Block Versus Infraclavicular Regional Nerve Block in Distal Radial Open Reduction and Internal Fixation: A Retrospective Case Series

Kukreja¹,

Kofskey²,

Ransom³

et al. 2022

Cureus

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BackgroundThe management of pain in patients undergoing open reduction and internal fixation (ORIF) of distal radius fractures (DRFs) remains an area of debate for anesthesiologists due to a variety of block options and no definitive superior technique among these modalities. In this retrospective case series, we compare the efficacy of supraclavicular versus infraclavicular regional nerve blocks for surgical patients undergoing distal radial ORIF operations to determine if one approach was superior. MethodologyThis retrospective case series included patients undergoing ORIF of a DRF at a tertiary academic medical center between April 28, 2016, and August 23, 2021. In total, 54 patients undergoing ORIF of a DRF provided written consent for the nerve block(s) on the day of surgery. Of these 54 patients, 54 (100%) underwent primary procedures. Of the 54 primary ORIF patients, 28 (52%) received the supraclavicular block, while 26 (48%) received the infraclavicular nerve block. ResultsThe infraclavicular and supraclavicular groups did not significantly differ regarding age, gender, American Society of Anesthesiologists, weight, or body mass index. The primary (intraoperative opioid use) and secondary (postoperative opioid use, postoperative nausea and vomiting in the post-anesthetic care unit, highest and average pain scores, and time to discharge) outcomes data were included in the study. The infraclavicular and supraclavicular groups did not significantly differ in any of the assessed outcomes except for time to discharge. ConclusionsThe supraclavicular block approach for distal radius ORIF offers an effective and non-inferior alternative to the infraclavicular block approach concerning effective analgesia and safety.

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Section: Discussionsupporting

confidence: 41%

Comparison of Supraclavicular Regional Nerve Block Versus Infraclavicular Regional Nerve Block in Distal Radial Open Reduction and Internal Fixation: A Retrospective Case Series

Kukreja¹,

Kofskey²,

Ransom³

et al. 2022

Cureus

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“…In the Techasuk et al ( 6) study, the targeted intracluster approach has been compared with 2 injections (corner pocket + cluster approach) in one plane, but we do not use the corner pocket approach despite its high success rate because it is associated with greater risks of pneumothorax or subclavian artery puncture owing to the anatomic accessibility of the block needle to pleura or subclavian artery (4,7,8).…”

Section: Discussionmentioning

confidence: 99%

A Randomized Comparison Between Two Injections from Two Planes versus Two Injections with a Uniplanar Approach for Ultrasound-Guided Supraclavicular Block

et al. 2020

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BACKGROUND: The brachial plexus courses along the lateral to posterior aspect of the subclavian artery located within the supraclavicular region as a trunk or division. Therefore we hypothesized that 2 injections, one along the lateral and one along the posterior aspect of the brachial plexus, could be performed by changing the angle of the ultrasound probe, thereby achieving a 3-dimensional (3-D) even distribution of local anesthetics. Previously, we confirmed the efficacy of this type of approach with that of a single cluster approach. These findings represent a subsequent study. OBJECTIVES: This study was conducted to confirm the superiority of block quality achieved by 2 injections from 2 planes (control group; group C) over 2 injections in one plane (experimental group; group E). STUDY DESIGN: A randomized, controlled trial. SETTING: Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center. METHODS: In group C (n = 35), the brachial plexus sheath was penetrated in 2 planes by anteriorly altering the angle of the ultrasound probe without changing its position. In group E (n = 35), the upper and lower portions of the brachial plexus sheath were penetrated in one plane. A total of 15 mL of lidocaine 1.5% containing epinephrine (1:200,000) was injected at each point in both groups. The ultrasound-guided supraclavicular brachial plexus block was evaluated every 5 minutes for 30 minutes. The main outcome variables were rates of blockage of all 4 nerves and ulnar nerve sparing. RESULTS: The rate of blockage of all 4 nerves (median, ulnar, radial, and musculocutaneous nerves) was not significantly different between the 2 groups (94% in group C vs. 86% in group E, respectively; P = 0.232). The number of spared ulnar nerves was similar (1 vs. 5, respectively; P = 0.088). Group procedure times, onset times, and Visual Analog Scale scores for the blocks were similar. LIMITATIONS: For the 2 plane, 2 injection approach, only 2-D imaging was performed rather than 3-D imaging. CONCLUSIONS: Two injections performed in one plane offered similar benefits to 2 injections performed in 2 planes. The 2 techniques provided comparable block qualities and could be viewed as equally effective alternatives. KEY WORDS: Brachial plexus block, multiple injection, supraclavicular block, ultrasound

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“…The corner pocket approach is a well-utilized method in USSCBPB. The target for the needle tip placement is the corner bordered by the subclavian artery medially and the first rib and pleura inferiorly [ 2 , 6 , 11 ]. The local anesthetic is deposited at this point; therefore, the divisions of the brachial plexus float superiorly [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…The local anesthetic is deposited at this point; therefore, the divisions of the brachial plexus float superiorly [ 2 ]. Many authors suggest that this approach can achieve a dense and complete block of the entire upper extremity within minutes, and for this reason, it is often preferred [ 2 , 6 , 7 , 11 ]. However, it also has a risk of subclavian artery puncture and pneumothorax because the block needle needs to be advanced very close to the subclavian artery and pleura [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided central cluster approach for the supraclavicular brachial plexus block: a case series

Lee

Kim

et al. 2015

Korean J Anesthesiol

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There are many different approaches to ultrasound-guided supraclavicular brachial plexus block (US-SCBPB), and each has a different success rate and complications. The most commonly performed US-SCBPB is the corner pocket approach in which the needle is advanced very close to the subclavian artery and pleura. Therefore, it may be associated with a risk of subclavian artery puncture or pneumothorax. We advanced the needle into the central part of the neural cluster after penetrating the sheath of the brachial plexus in US-SCBPB. We refer to this new method as the "central cluster approach." In this approach, the needle does not have to advance close to the subclavian artery or pleura. The aim of this study was to evaluate the clinical outcomes of the central cluster approach in US-SCBPB.

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Eight Ball, Corner Pocket for Ultrasound-Guided Supraclavicular Block: High Risk for a Scratch

Cited by 7 publications

References 2 publications

Comparison of Supraclavicular Regional Nerve Block Versus Infraclavicular Regional Nerve Block in Distal Radial Open Reduction and Internal Fixation: A Retrospective Case Series

Comparison of Supraclavicular Regional Nerve Block Versus Infraclavicular Regional Nerve Block in Distal Radial Open Reduction and Internal Fixation: A Retrospective Case Series

A Randomized Comparison Between Two Injections from Two Planes versus Two Injections with a Uniplanar Approach for Ultrasound-Guided Supraclavicular Block

Ultrasound-guided central cluster approach for the supraclavicular brachial plexus block: a case series

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