Single-Stimulation, Low-Volume Infraclavicular Plexus Block: Influence of the Evoked Distal Motor Response on Success Rate

Abstract

We showed that evoked distal motor response influenced the success rate of single-injection infraclavicular plexus block. The highest success rate was obtained when injection was performed after radial nerve-type motor response.

Preliminary Evaluation of Infraclavicular Catheters Inserted Using Ultrasound Guidance: Through-the-Catheter Anesthesia Is Not Inferior to Through-the-Needle Blocks

“…Positioning of the catheter anterior to the posterior cord has been advocated by other practitioners 18 and corresponds best to the initial position chosen for first or single-injection, through-the-needle techniques previously described as highly successful. [15][16][17][18][19][20] In the present study, the structure immediately posterior to the artery that resembled a nerve was considered to be the posterior cord. Neurostimulation was not used to confirm its functional nature.…”

A Comparison Between Ultrasound-Guided Infraclavicular Block Using the “Double Bubble” Sign and Neurostimulation-Guided Axillary Block

“…5,6 The high success rate of ultrasound-guided ICB, using the double bubble sign to deposit LA posterior to the axillary artery, coincides with the findings of other authors using neurostimulation. 7 Despite the use of ultrasonography, we encountered two instances of vascular puncture in two patients in whom the needle tip could not be seen during the procedure. This underscores the importance of visualizing the entire needle.…”

Spread of Injectate Associated With Radial or Median Nerve–Type Motor Response During Infraclavicular Brachial-Plexus Block: An Ultrasound Evaluation

“…[7][8][9] This observation is certainly related to the anatomic location of the brachial plexus in the supracoracoid region. Our lateral approach to the brachial plexus allows reaching the emerging cords positioned side by side strictly lateral to the vessels.…”

“…7,9 During the procedure, patients were placed in supine position, with the head in neutral position, the upper arm adducted, the elbow flexed at 90°, and the forearm placed on the abdomen. The puncture site was located 1 cm cephalad to the coracoid process, central in the infraclavicular fossa (Fig 1).…”

“…[2][3][4][5][6] Nerve-stimulation studies suggest that the type of evoked distal motor response influences the success rate of single-injection infraclavicular-plexus block, with a highest success rate obtained when injection was performed after a radial-nerve-type motor response. [7][8][9] Recently, ultrasound has been successfully applied to guide injection during ICB placement. [10][11][12] We have combined nerve stimulation with blinded ultrasoundcontrolled ICB placement.…”