Clavipectoral Fascial Plane Block

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Clavipectoral Fascial Plane Block

Рет қаралды 44,417

Regional Anesthesiology and Acute Pain Medicine

Күн бұрын

In this video we discuss the anatomy, sonoanatomy and technique for performing the clavipectoral fascial plane block

Пікірлер: 22

@adziuba12 2 ай бұрын

Just when I thought there could be no more blocks to describe... you guys bring the knowledge. Appreciate it!

@drosmankaya Жыл бұрын

I have applied many cervical plexuses block for post operative analgesic effect, but awake clavicula surgery would be very advanced for me and my surgeon. :) very helpful video, thank you for your sharing.

@regionalanesthesiology 11 ай бұрын

Thanks for watching!

@uramalakia 10 ай бұрын

Found another gem. Thanks lots!

@edwardherrera4097 Жыл бұрын

Awesome. So far I’ve used the ISB plus CPB but it’s nice to have an option when avoiding hemiparesis is desired.

@regionalanesthesiology 11 ай бұрын

Agree, we have clavicle fracture cases where the surgeons want to evaluate the brachial plexus afterwards and this is a great option for that. Thanks for watching!

@DushyantsCHANNEL 16 күн бұрын

The surgeon operating exactly where you deposit your local anaesthetic volume is not a very confidence inspiring technique, personally. But yes, where avoidance of phrenic palsy is paramount, this is good to have in the backpocket.

@BassGuyNL 2 ай бұрын

Great video! Would you consider performing this block after induction of general anesthesia, prior to surgical incision?

@regionalanesthesiology Ай бұрын

Yes, I think that's a great way to do it. It's pretty quick to do so you're not going to take up a lot of surgical time, and it avoids the discomfort of needling the periosteum while awake. Thanks for watching!

@drvinodprakash Жыл бұрын

Thanks ❤

@regionalanesthesiology 11 ай бұрын

Thanks for watching!

@iqtidarbaig8532 11 ай бұрын

Excellent sir. Picture at 2.50 doesn't give broad view about needle position, ( location of neck, chest, shoulder etc) please explain it. Thanks

@regionalanesthesiology 11 ай бұрын

Sorry if that wasn't clear...the probe is over the clavicle, with the shoulder to the left side of the screen. The patient's neck and head are in the upper right part of the screen, and the needle is being advanced from the caudal aspect. Hope that helps!

@mjonesCO Жыл бұрын

I’ve used this technique for about a year now and absolutely love it. However, I am curious as to how long prior to incision do you perform the clavipectoral fascia block? I ask because I have noticed some patients do great during the case and even in phase 1 of pacu but the block seems to wear off quickly while others get the relief I’d expect 18 to 24 hours.

@igork7346 Жыл бұрын

Hello! In my practise combinate this block with cervical plexus block. 10-15 minutes after block may get surgery (lidocaine 1% + ropivacaine 0.375%). I think only ropivacaine solution will need a little bit more time before surgery.

@angelgomez5388 Жыл бұрын

Do you use any adjuvants?

@mjonesCO Жыл бұрын

@@angelgomez5388 yes, decadron. I switched from 0.25% to 0.5% and it seems to work better.

@regionalanesthesiology 11 ай бұрын

Glad it's working well for you! I usually use a dilute solution of ropivacaine (0.2%) with epinephrine (2.5 mcg/ml) and dexamethasone (2 mg)--that combo typically provides 16-24 hrs of coverage. Hope that helps!

@doctorbius 4 ай бұрын

@@mjonesCOthis is for awake anaesthesia?

@ayman63ayman Жыл бұрын

this block can be used as anesthesia or analgesia ?

@igork7346 Жыл бұрын

I think a both. Low percent solution for analgesia, high percent for anesthesia.

@regionalanesthesiology 11 ай бұрын

Usually we're combining this with a light general anesthetic with LMA in order to provide patient comfort and immobility, so it's usually just an analgesic block. I have done it sometimes for surgical anesthesia but as @igork7346 mentioned, it's useful to increase the concentration to hasten the onset and provide a denser block (e.g. 0.375% ropivacaine). I'll also do a quick cervical plexus block in order to make SURE that I've blocked the skin fibers over the clavicle. Thanks for watching!