Ultrasound-Guided Medial Versus Lateral Approach of the Costoclavicular Block: A Prospective Randomized Study

Area of Science:

• Regional anesthesia
• Anesthesiology
• Ultrasound-guided procedures

Background:

• Costoclavicular block targets the brachial plexus in the infraclavicular fossa.
• This block can be performed using either a medial or lateral approach.

Purpose of the Study:

• To compare the anesthetic efficacy and block dynamics of the medial versus lateral costoclavicular block approaches.
• Evaluate surgeon and patient satisfaction and complication rates.

Main Methods:

• Eighty-eight patients undergoing upper extremity surgery were randomized to medial (n=44) or lateral (n=44) approach under ultrasound guidance.
• Both groups received 20 mL of local anesthetic via an in-plane technique.
• Sensory/motor block onset, block dynamics, and complications were assessed.

Main Results:

• Anesthesia onset time, surgical duration, and procedure type were similar between groups.
• The medial approach showed a greater needle-pleura distance and shorter motor block onset time.
• No significant differences in complications, additional analgesia needs, or patient/surgeon satisfaction were observed.

Conclusions:

• The medial costoclavicular block approach is as effective as the lateral approach for regional anesthesia.
• Both approaches provide comparable anesthetic efficacy and patient outcomes.