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Indirect versus direct measurement of brachial plexus depth
P B Cornish1, L J Greenfield, M O'Reilly
1Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, USA.
Anesthesia and Analgesia
|May 13, 1999
Summary
Estimating brachial plexus depth in the supraclavicular fossa can prevent pneumothorax. This study found that patient weight and a skin reference point accurately predict nerve and lung depth for safer supraclavicular nerve blocks.
Area of Science:
- Anesthesiology
- Anatomy
- Surgical Technique
Background:
- Supraclavicular nerve blocks are effective for surgical anesthesia.
- Pneumothorax is a potential complication of supraclavicular nerve blocks.
- Accurate needle placement is crucial to avoid lung injury.
Purpose of the Study:
- To develop a technique for estimating brachial plexus and lung depth in the supraclavicular fossa.
- To minimize the risk of pneumothorax during supraclavicular nerve blocks.
- To guide needle placement for safer brachial plexus access.
Main Methods:
- Measurements of a skin reference point relative to the clavicle were taken.
- Intraoperative depths of the brachial plexus, artery, and pleura were recorded.
- Correlation between patient characteristics (weight) and anatomical depths was analyzed.
Main Results:
- The reference point's height above the clavicle correlated with plexus depth.
- Pleural depth was significantly different from the reference point's height.
- Patient weight significantly correlated with the depths of the plexus, artery, and pleura.
Conclusions:
- Accurate estimation of brachial plexus depth is feasible in the supraclavicular fossa.
- This technique can help avoid lung proximity during needle insertion.
- The findings support a safer approach to supraclavicular nerve blocks.