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Chapter: Clinical Cases in Anesthesia : Brachial Plexus Anesthesia

Describe the infraclavicular approach to blocking the brachial plexus

There are several different approaches to the infraclavic-ular block.

Describe the infraclavicular approach to blocking the brachial plexus.

 

There are several different approaches to the infraclavic-ular block. One effective technique uses the coracoid process as the major landmark. With the patient supine, head turned to the contralateral side, and arms at the side, the coracoid process is identified. One then measures 2 cm caudad and 2 cm medial to the coracoid. Using a 22G 4-inch insulated needle attached to a nerve stimulator, the needle is aimed posteriorly and laterally. When forearm and hand twitches are elicited at or below 0.4 mA, the local anesthetic is injected, making sure to aspirate after every 5 cc. A catheter can be inserted for postoperative pain relief. For a long-acting block, 40 cc of bupivacaine 0.5% is effective.

 

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Clinical Cases in Anesthesia : Brachial Plexus Anesthesia : Describe the infraclavicular approach to blocking the brachial plexus |


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