Infraclavicular brachial plexus block for regional anaesthesia of the lower arm

Postoperative Pain and Other Acute Pain Syndromes

“…This block has a lower likelihood of tourniquet pain during surgery and provides more reliable blockade of the musculocutaneous and axillary nerves than does a single-injection axillary block. 236 Many investigators have confirmed that when using UGRA for an infraclavicular block, a single injection of local anesthetic posterior to the axillary artery is as effective as multiple injections. [237][238][239] A randomized comparison of infraclavicular and supraclavicular PNCs for postoperative analgesia showed that local anesthetic infusion via an infraclavicular PNC provides analgesia superior to that via a supraclavicular PNC.…”

Upper-Extremity Peripheral Nerve Blocks in the Perioperative Pain Management of Orthopaedic Patients

“…5-A). The surface landmarks for injection are shown in Figure 5-C. Infraclavicular nerve blocks have classically had a low pneumothorax prevalence (0.7%) 37 but, as noted above, the increasing use of ultrasonographic guidance has increased the safety profile of brachial plexus blocks in general, including periclavicular blocks 11 .…”

“…Shoulder and elbow reconstruction, open soft-tissue procedures, and arthroscopic interventions can all result in severe pain. The use of peripheral nerve blocks can improve patient satisfaction, minimize associated perioperative complications related to narcotic use, increase surgical efficiency, shorten hospital stays, and enhance overall cost-effectiveness (Tables II 10, 12,13,16,17,19,20 and III 9,11,14,15,18 ). The interscalene nerve block, considered the gold standard for regional anesthesia of the shoulder, has been the most widely studied with regard to outcome measures.…”

“…Alternatives to the interscalene nerve block, such as the periclavicular blocks (supraclavicular nerve block and/or infraclavicular nerve block) and the combination of a suprascapular nerve block and an axillary nerve block, have also shown effectiveness for procedures involving the upper extremity 11,18,41,52,54 . Checcucci et al 54 described the latter ''shoulder block'' (a suprascapular nerve block in combination with an axillary nerve block) as an alternative to an interscalene nerve block for arthroscopic procedures and reported 100% patient satisfaction.…”

“…Traditional pain management includes general anesthesia and narcotic medication for surgery, followed by oral and intravenous pain medications, including patient-controlled analgesia, after surgery. The use of peripheral nerve blocks for upperextremity procedures has led to improved postoperative pain control, decreased narcotic use, and decreased narcotic-associated side effects such as nausea and vomiting [9][10][11][12][13][14][15][16][17][18][19][20] . Accordingly, the duration of hospital stays has been reduced, and procedures previously performed in an inpatient care setting are being performed on an outpatient basis 20 .…”