Ultrasound-Guided Infraclavicular Block

Infraclavicular brachial plexus block permits anesthesia of the plexus where most of the major motor and sensory nerves to the arm are anesthetized.

Infraclavicular block is used to provide anesthesia and analgesia for procedures involving the distal arm and elbow, wrist, forearm, and hand.

practitioners injected local anesthetic into or around the individual cords.

Once the visualization of local anesthetic spread around the axillary artery is achieved, a 90% success rate is usually accomplished.

Anatomy:

• Beneath the clavicle, the cervicoaxillary canal is formed, bounded by the first rib below and the clavicle above.
• The infraclavicular fossa is formed between the pectoralis major muscle and the deltoid muscle.
•  Needle insertion for infraclavicular block at this point will traverse the pectoralis major and pectoralis minor muscles en route to the plexus
• Posterior to the neurovascular bundle is the rib cage and, posteromedially, the pleura and lung.

 

• The cords of the brachial plexus are closely aligned with the axillary artery at the infraclavicular region and derive their names from their position with respect to the vessel: posterior, lateral, and medial
• The infraclavicular plexus lies deeper than at other sites of the brachial plexus.

The cords of the plexus typically appear hyperechoic, or bright, in the infraclavicular region