A novel supraclavicular approach to brachial plexus block

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Surgical Procedures

Background:

• Brachial plexus blocks are crucial for upper limb surgery and pain management.
• Existing techniques may have limitations in accessibility or efficacy.
• A novel approach is needed to improve patient outcomes and procedural ease.

Purpose of the Study:

• To introduce and evaluate a new supraclavicular brachial plexus block technique.
• To assess the efficacy and safety of the intersternocleidomastoid approach.
• To determine its utility in elective surgery, physiotherapy, and pain management.

Main Methods:

• The intersternocleidomastoid technique was developed and tested on unembalmed cadavers.
• 150 patients (ASA grade I or II) undergoing upper limb procedures or pain management received the block.
• Surface landmarks (sternocleidomastoid heads triangle) were used for guidance, with success rates and complication profiles documented.

Main Results:

• The technique utilized a simple, palpable landmark in 90% of patients.
• Intraoperative anesthesia was satisfactory in 93% of patients.
• Postoperative analgesia lasted ≥24 hours in 63 patients, with a low incidence of minor complications like phrenic nerve block (60%) and Horner's syndrome (10%). No pneumothorax occurred.

Conclusions:

• The intersternocleidomastoid technique is an effective and easily learned method for brachial plexus blockade.
• It provides good anesthesia and analgesia with a favorable safety profile.
• This novel approach is suitable for various upper limb indications, including surgery and pain management.