Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space: A Cadaver Anatomic Study

Area of Science:

• Anatomy
• Regional Anesthesia
• Surgical Anatomy

Background:

• The costoclavicular space (CCS) is a potential alternative site for infraclavicular brachial plexus block.
• Limited anatomical data exists for the brachial plexus within the CCS.

Purpose of the Study:

• To define the anatomical relationships of the brachial plexus cords within the CCS.
• To establish an anatomical basis for ultrasound-guided blocks at this site.

Main Methods:

• Anatomical dissection of 8 fresh adult human cadavers.
• Evaluation using transverse anatomical and histological sections of the CCS.

Main Results:

• Brachial plexus cords are consistently located lateral and parallel to the axillary artery in the CCS.
• The lateral cord is superficial and anterior to the medial and posterior cords.
• The medial and posterior cords exhibit a consistent positional relationship to each other and the lateral cord.

Conclusions:

• The brachial plexus cords form a clustered, consistent anatomical pattern within the CCS.
• This consistent topography supports the CCS as a reliable landmark for ultrasound-guided infraclavicular brachial plexus blocks.