Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks : Clinical, Pharmacological, and Anatomical Considerations
Copyright © 2021, Author(s)..
Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have quicker onset time, and have lower rates of complications than other approaches (axillary, interscalene, etc.). Ultrasound-guidance is commonly utilized to improve outcomes, limit the need for deep sedation or general anesthesia, and reduce procedural complications. Given the SC and IC approaches are the most common approaches for brachial plexus blocks, the differences between the two have been critically evaluated in the present manuscript. Various studies have demonstrated slight favorability towards the IC approach from the standpoint of complications and safety. Two prospective RCTs found a higher incidence of complications in the SC approach - particularly Horner syndrome. The IC method appears to support a greater block distribution as well. Overall, both SC and IC brachial plexus nerve block approaches are the most effective and safe approaches, particularly under ultrasound-guidance. Given the success of the supraclavicular and infraclavicular blocks, these techniques are an important skill set for the anesthesiologist for intraoperative anesthesia and postoperative analgesia.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Anesthesiology and pain medicine - 11(2021), 5 vom: 20. Okt., Seite e120658 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kaye, Alan D [VerfasserIn] |
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| Links: |
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| Themen: |
Brachial Plexus |
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| Anmerkungen: |
Date Revised 26.01.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5812/aapm.120658 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336099215 |
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| 500 | |a Date Revised 26.01.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2021, Author(s). | ||
| 520 | |a Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have quicker onset time, and have lower rates of complications than other approaches (axillary, interscalene, etc.). Ultrasound-guidance is commonly utilized to improve outcomes, limit the need for deep sedation or general anesthesia, and reduce procedural complications. Given the SC and IC approaches are the most common approaches for brachial plexus blocks, the differences between the two have been critically evaluated in the present manuscript. Various studies have demonstrated slight favorability towards the IC approach from the standpoint of complications and safety. Two prospective RCTs found a higher incidence of complications in the SC approach - particularly Horner syndrome. The IC method appears to support a greater block distribution as well. Overall, both SC and IC brachial plexus nerve block approaches are the most effective and safe approaches, particularly under ultrasound-guidance. Given the success of the supraclavicular and infraclavicular blocks, these techniques are an important skill set for the anesthesiologist for intraoperative anesthesia and postoperative analgesia | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Brachial Plexus | |
| 650 | 4 | |a Infraclavicular | |
| 650 | 4 | |a Peripheral Nerve Blocks | |
| 650 | 4 | |a Regional Anesthesia | |
| 650 | 4 | |a Supraclavicular | |
| 650 | 4 | |a Ultrasound-Guided | |
| 700 | 1 | |a Allampalli, Varsha |e verfasserin |4 aut | |
| 700 | 1 | |a Fisher, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Kaye, Aaron J |e verfasserin |4 aut | |
| 700 | 1 | |a Tran, Aaron |e verfasserin |4 aut | |
| 700 | 1 | |a Cornett, Elyse M |e verfasserin |4 aut | |
| 700 | 1 | |a Imani, Farnad |e verfasserin |4 aut | |
| 700 | 1 | |a Edinoff, Amber N |e verfasserin |4 aut | |
| 700 | 1 | |a Djalali Motlagh, Soudabeh |e verfasserin |4 aut | |
| 700 | 1 | |a Urman, Richard D |e verfasserin |4 aut | |
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