Abstract
A new technique for achieving brachial plexus anaesthesia through the supraclavicular fossa is described. Its objectives are to minimize risk to the lung and provide for continuous as well as single-shot options. The plexus is approached through the lateral aspect of the supraclavicular fossa, and a bend in the shaft of the needle permits the tip of the needle to be directed tangential to the chest wall. An audit of 572 cases associated with the development of this technique is presented.
References
1.
Lanz
E.L.
,
Theiss
D.
,
Jankovic
D.
The extent of blockade following various techniques of brachial plexus block. Anesth Analg 1983 ; 62 : 55 –58 .
2.
Moore
D.C.
,
Bridenbaugh
L.D.
: Pneumothorax: its incidence following brachial plexus block analgesia. Anesthesiology 1953 ; 15 : 475 –479 .
3.
Fortin
G.
,
Tremblay
L.
The short needle technique in brachial plexus block. Can Anaesth Soc J 1959 ; 6 : 32 –39 .
4.
Winnie
A.P.
,
Collins
V.J.
The subclavian perivascular technique of brachial plexus anesthesia. Anesthesiology 1964 ; 25 : 353 –363 .
5.
Korbon
G.A.
,
Carron
H.
,
Lander
C.J.
First rib palpation: a safer, easier technique for supraclavicular brachial plexus block. Anesth Analg 1989 ; 68 : 682 –685 .
6.
Moorthy
S.S.
,
Schmidt
S.I.
,
Dierdorf
S.F.
,
Rosenfeld
S.F.
,
Anagnostou
J.M.
A supraclavicular lateral paravascular approach for brachial plexus regional anaesthesia. Anesth Analg 1991 ; 72 : 241 –244 .
7.
Brown
D.L.
,
Cahill
D.R.
,
Bridenbaugh
L.D.
Supraclavicular nerve block: anatomic analysis of a method to prevent pneumo-thorax. Anesth Analg 1993 ; 76 : 530 –534 .
8.
Bauld
T.J.
IRB transmitted on manually bent, insulated needle. Biomedical Engineering Unit, University of Michigan , 1994 .
9.
Cornish
P.B.
,
Greenfield
L.J.
,
O'Reilly
M.
,
Allan
L.
Indirect vs direct measurement of brachial plexus depth. Anesth Analg 1999 ; 88 : 1113 –1116 .
10.
Hickey
R.
,
Garland
T.A.
,
Ramamurthy
S.
Subclavian peri-vascular block: influence of location of paresthesia. Anesth Analg 1989 ; 68 : 767 –771 .
11.
Cornish
P.B.
,
Greenfield
L.J.
Brachial plexus anatomy. Reg Anesth 1997 ; 22 : 106 –107 .
12.
Knoblanche
G.E.
The incidence and aetiology of phrenic nerve blockade associated with supraclavicular brachial plexus block. Anaesth Intensive Care 1979 ; 7 : 346 –349 .
13.
Boezaart
A.P.
,
de Beer
J.F.
,
du Toit
C.
,
van Rooyen
K.
: A new technique of continuous interscalene nerve block. Can J Anesth 1999 ; 46 : 275 –281 .
14.
Cornish
P.B.
: Supraclavicular regional anaesthesia revisited. Anaesth Intensive Care 2000 ; 28 : 106 –107 .
