The Influence of Arm Abduction on the Anatomic Relations of Infraclavicular Brachial Plexus: An Ultrasound Study

Ruíz, Ana; Sala, Xavier Pintó; Bargalló, Xavier; Hurtado, Paola; Arguís, M.J.; Carrera, Ana

doi:10.1213/ane.0b013e31818c94da

Cited by 35 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar with our data, Ruíz et al (17) reported that the depth of the brachial plexus is reduced with the abduction of the arm. Frkovic et al (3) implied that improved visibility of nerves at abduction of the arm may be linked with the anatomical re-arrangement of the plexus or compression of tissues in various positions.…”

Section: Discussionsupporting

confidence: 93%

Importance of the Upper Extremity Position for a Safe and Effective Axillary Block: a Comparative Study

Öztürk¹,

Tezcan²,

Bilge³

et al. 2017

Turk J Anaesth Reanim

View full text Add to dashboard Cite

Objective: Our aim was to determine the ideal position of upper extremities during ultrasonography guidance for axillary block. The position that provides the shortest distance between the median and musculocutaneous nerves was assumed to be the most appropriate position for axillary block. Methods:In this cross-sectional study, 120 (45 female and 75 male) patients were placed in a position with a shoulder at 90° / elbow 90° (position 1) and a shoulder 90° / elbow 0° (position 2). The intersection point of the biceps brachii muscle with the lower border of the pectoralis major muscle is defined as the proximal level (P). Distal level (D) is reffered as 5 cm below the proximal level. In the positions described above, the distance between median and musculocutaneous nerves was measured proximal (positions 1P and 2P) and distal levels (positions 1D and 2D). It was investigated whether these measurements differed between the groups and whether the body mass index or the gender. Results:The shortest mean distance (10.24±3.95 mm) between the two nerves was determined when the shoulder position 90°/ elbow position 0° at the distal level (1D) and the longest mean distance (13.41±4.26 mm) was determined when shoulder position 90°/elbow position 90° at the proximal level (2P). In all four cases, there was no difference in the results between men and women. There was no relationship between the measurement results and the body mass indexes and age of the patients. Conclusion:Appropriate positioning of the upper extremities is important for achieving optimal position during axillary block. Thereby, the procedure can be safely and effectively performed with lesser amounts of local anaesthetic solution and a decreased number of manoeuvres with needle during infiltration.Keywords: Axillary block, ultrasound guidance, median nerve, musculocutaneous nerve Amaç: Amacımız, ultrason kılavuzluğunda yapılan aksiller blok sı-rasında üst ekstremitenin ideal pozisyonunu belirlemektir. Median ve muskulokutanöz sinirler arasında en kısa mesafeyi sağlayan pozisyonun aksiller blok için en uygun pozisyon olduğu varsayılmıştır.Yöntemler: Bu kesitsel çalışmada 120 (45 kadın ve 75 erkek) hastada her bir kola omuz 90°/dirsek 90°'de (pozisyon 1) ve omuz 90°/dirsek 0°'de (pozisyon 2) olacak şekilde pozisyon verildi. Pektoralis major kasının alt sınırıyla biseps brachii kasının kesişme noktası proksimal seviye (P) olarak tanımlanmıştır. P'nin 5 cm distaline distal seviye (D) denilmiştir. Yukarıda anlatılan pozisyonlarda median ve muskulokutanöz sinirler arasındaki mesafe proksimal (pozisyon 1P ve 2P) ve distal seviyelerde (pozisyon 1D ve 2D) ölçüldü. Tüm bu ölçümlerin gruplar arasında farklılığı ve hastaların beden kitle indeksi yada cinsiyetiyle değişiklik gösterip göstermediği araştırıldı. Bulgular:İki sinir arasındaki en kısa ortalama mesafe (10,24±3,95 mm) distal seviyede omuz 90°/dirsek 0° pozisyonda (1D), en uzun ortalama mesafe (13,41±4,26 mm) ise proksimal seviyede omuz 90°/dirsek 90° pozisyonda (2P) iken saptanmıştır. Dört durumda da sonuç...

show abstract

Section: Discussionsupporting

confidence: 93%

Importance of the Upper Extremity Position for a Safe and Effective Axillary Block: a Comparative Study

Öztürk¹,

Tezcan²,

Bilge³

et al. 2017

Turk J Anaesth Reanim

View full text Add to dashboard Cite

show abstract

“…7 Published data indicate that there are changes in the configuration of the neurovascular bundle at the LICF with position (ie, abduction or adduction) of the arm. 12 However, there are no data describing such variation at the CCS. It is our observation, during costoclavicular BPB, that the position of the cords remains relatively constant with change in the position of the arm.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space

Sala‐Blanch

Reina

Pangthipampai

et al. 2016

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

show abstract

“…With the arm abducted 90 degrees and the coracoid process used as a surface landmark, the transducer is oriented in the parasagittal plane with its midpoint slightly medial and caudad to the coracoid process 77,78 (Fig. 53.10).…”

Section: Ultrasound-guided Techniquementioning

confidence: 99%

Upper Extremity Blocks

Neal¹,

Mariano²,

Salinas³

2014

Practical Management of Pain

View full text Add to dashboard Cite

The Influence of Arm Abduction on the Anatomic Relations of Infraclavicular Brachial Plexus: An Ultrasound Study

Abstract: Abduction of the arm reduces the depth of the brachial plexus but does not change the position of the axillary artery relative to the coracoid process or the pleura. Ultrasonography may under-estimate the actual depth of the plexus.

Cited by 35 publications

References 7 publications

Importance of the Upper Extremity Position for a Safe and Effective Axillary Block: a Comparative Study

Importance of the Upper Extremity Position for a Safe and Effective Axillary Block: a Comparative Study

Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space

Upper Extremity Blocks

Contact Info

Product

Resources

About