Infraclavicular Brachial Plexus Block
Regional Anesthesia and Chronic Pain Applications
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Clinical Significance
of Infraclavicular Brachial Plexus Blocks
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For surgery below the shoulder and when positioning is constrained due to limited shoulder abduction, infraclavicular brachial plexus blocks are an alternative for supraclavicular and axillary blocks.
Advantages of an Infraclavicular Brachial Plexus Block
- Lower Risk
of pneumothorax - Easy and safe with Ultrasound guidance
- Quick time to set up
- Ease of placing catheter
Infraclavicular Brachial Plexus Block
High-frequency linear probes, (10 to 15 MHz), are best suited for imaging the brachial plexus in most locations
EXCEPT in the infraclavicular region where the cords may be more deeply located and thus probes in the 4 to 7 MHz range may be required
Ultrasound-guided
Infraclavicular Brachial Plexus Block
- Cords- hyperechoic
- Lateral cord commonly cephalad
- Posterior cord posterior to the artery
- Medial cord in this region can often be seen between the artery and vein, but is not always visible
References
and Interesting Articles...
- Williams LM, Singh K, Dua A, et al. Infraclavicular Nerve Block. [Updated 2022 Jun 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537016/
- Abhinaya RJ, Venkatraman R, Matheswaran P, Sivarajan G. A randomised comparative evaluation of supraclavicular and infraclavicular approaches to brachial plexus block for upper limb surgeries using both ultrasound and nerve stimulator. Indian J Anaesth. 2017 Jul;61(7):581-586. Link
- Kavrut Ozturk N, Kavakli AS. Comparison of the coracoid and retroclavicular approaches for ultrasound-guided infraclavicular brachial plexus block. J Anesth. 2017 Aug;31(4):572-578. doi: 10.1007/s00540-017-2359-6. Epub 2017 Apr 18. PMID: 28421316. Link
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