Infraclavicular Brachial Plexus Block for Regional Anaesthesia of the Lower Arm

Abstract

ICB is a safe and simple technique for providing surgical anaesthesia of the lower arm, with an efficacy comparable to other BPBs. The advantages of ICB include a lower likelihood of tourniquet pain during surgery, and more reliable blockade of the musculocutaneous and axillary nerves when compared to a single-injection axillary block. The efficacy of ICB is likely to be improved if adequate time is allowed for block onset (at least 30 minutes) and if a volume of at least 40 ml is injected. Since publication of many of the trials included in this review, it has become clear that a distal posterior cord motor response is the appropriate endpoint for electrostimulation-guided ICB; we recommend it be used in all future comparative studies. There is also a need for additional RCTs comparing ultrasound-guided ICB with other BPBs.

Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

“…We consider APB in DEB thus feasible and safe, although we are aware that our cohort is too small to draw definitive conclusions. Complications of ultrasound-guided APB in general are described as very low and mostly transient (11) even in pediatric patients. To underline our previously published results (4), the sedation procedure is safe, easy to perform in experienced hands and does not lead to hazardous airway complications.…”

Regional anaesthesia: what surgical procedures, what blocks and availability of a “block room”?

“…In day case surgery of the hand and wrist with the use of an infraclavicular nerve block, there was less tourniquet pain in comparison with an axillary block [83]. Discharge was faster and less adverse events and better pain scores were achieved when compared to general anaesthesia [84].…”

Double axillary vein variation diagnosed with ultrasound guidance during infraclavicular nerve block intervention

“…The infraclavicular nerve block is a frequently preferred anaesthetic technique for elbow and upper limb surgery. It has several advantages such as lower likelihood of tourniquet pain, a reliable blockade of the musculocutaneous nerve and a simpler and safer approach when compared with multi-injection axillary nerve block and mid-humeral blocks 3. However, the risk of complications increases in the presence of anatomical variations.…”