[Infraclavicular block of the brachial plexus - an improved coracoid technique]

The technique of coracoid block described by Whiffler has been improved by use of neurostimulator (Stimuplex--B. Braun) and changing the angle of insertion of the neurostimulation needle (Stimuplex needle A150, 0.90 x 150 mm). As a result, together with the advantages of the technique proposed by Whiffler, a strict perineural distribution of the anesthetic solution is achieved, the risk of vascular lesions is excluded and the effective block is achieved by using lower quantity of local anesthetic--0.5 ml/kg 1% lidocaine and adrenalin (1:200,000). Clinical appearance of the coracoid block by means of the technique we propose was investigated in 35 patients who underwent surgical treatment in the region of elbow, forearm and hand. The acquired results of the alteration of the sensitivity and motor function prove an effective block within all the regions distally of the upper brachium in 91.4 of the patients and no complications. The proposed technique of coracoid block is a safe and easily performed method for regional anesthesia routinely applied in planned, urgent and outpatient surgery of the upper extremity.