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Ultrasound-guided supraclavicular brachial plexus block
Vincent W S Chan1, Anahi Perlas, Regan Rawson
1*Department of Anesthesia, University of Toronto; and †Department of Anesthesia, Toronto Western Hospital, Toronto, Ontario, Canada.
Anesthesia and Analgesia
|October 23, 2003
Summary
High-resolution ultrasound reliably guides supraclavicular brachial plexus blocks. This imaging technique enhances nerve localization and local anesthetic spread visualization, improving block success rates in outpatients.
Area of Science:
- Anesthesiology
- Medical Imaging
- Regional Anesthesia
Background:
- Supraclavicular brachial plexus blocks are crucial for upper extremity surgery.
- Accurate nerve localization is essential for block efficacy and safety.
- Traditional landmark-based techniques have limitations.
Purpose of the Study:
- To evaluate the efficacy and reliability of high-resolution ultrasound for supraclavicular brachial plexus blocks.
- To assess ultrasound's role in nerve identification, needle guidance, and local anesthetic spread visualization.
Main Methods:
- Forty outpatients undergoing supraclavicular brachial plexus blocks were studied.
- Ultrasound imaging was used for real-time guidance of needle advancement.
- Nerve stimulation confirmed needle position prior to local anesthetic injection.
Main Results:
- Ultrasound reliably identified the brachial plexus and surrounding structures.
- The block was successful in 95% of cases after a single attempt.
- No pneumothorax occurred; failures were due to injection technique errors.
Conclusions:
- Real-time ultrasound imaging significantly facilitates nerve localization and needle placement.
- Ultrasound visualization of local anesthetic spread confirms accurate needle tip location.
- This technique improves the safety and effectiveness of supraclavicular brachial plexus blocks.