Supraclavicular Brachial Plexus Block

Рет қаралды 144,411

Regional Anesthesiology and Acute Pain Medicine

Күн бұрын

In this video, we discuss the anatomy, indications, and technique for ultrasound guided supraclavicular brachial plexus block

Пікірлер: 34

@DontEatCream 3 жыл бұрын

That is a beautiful block, with excellent technique. Very nice!

@ooommm4024 Жыл бұрын

I have had this a couple of times for shoulder // arm orthopedic surgery and am quite impressed with the amount of pain relief it provides. I had almost zero pain post-op and got a bit of a giggle as my arm was completely paralyzed for 1-2 days after.

@edwardherrera846 2 жыл бұрын

Great video. Great block.

@sumssums9121 2 жыл бұрын

EXCELLENT VIDEO

@alavyshammi4764 2 жыл бұрын

Excellent 😊😊😊 Thanks

@dbash3428 2 жыл бұрын

Thank you for making this high quality helpful video. I did notice that as opposed to this video the NYSORA video and website stated that needle should be placed within the brachial plexus sheath.

@dbash3428 2 жыл бұрын

@@regionalanesthesiology Thank you for your response and thoughtful editorial!

@doctorbius 6 ай бұрын

I was wondering the same

@doctorbius 6 ай бұрын

I was wondering the same

@drvinod0072004 3 жыл бұрын

Nice video .. thank u

@richardshoenfeld8190 3 жыл бұрын

Excellent teaching video, particularly with respect to use of hydrodissection and avoiding violation of the plexus sheath. Comment on quantity of local anesthetic to use to improve chances of block success was greatly appreciated.

@snakegaming4411 2 жыл бұрын

Excellent video and information about not violating the sheath...I see they do violate all the time...

@No-xh2cs 5 ай бұрын

0.5 ropi or bupivacaine will get you a surgical block and add epi to prevent intravascular spread

@mahfouz8397 11 ай бұрын

Amazing demo

@regionalanesthesiology 10 ай бұрын

Thanks!!

@niranjanm3924 Жыл бұрын

Is there grading for upper limb blocks for sensory and motor onset (like modified bromage scale for lower limbs)?

@ludysm5113 Жыл бұрын

Top 🔝

@georgeking1794 2 ай бұрын

Wondering how long it takes for this method of not entering the sheath to work?

@williamtellez6660 Жыл бұрын

Enjoy all of your Videos. What block or blocks would you recommend for a patient having open surgery for a fractured patella where a fixator is to be used? Usually, surgery is associated with a painful recovery period.

@davidmiller2360 Жыл бұрын

@@regionalanesthesiology How do you decide on adductor canal vs. femoral nerve for knee procedures? I figured you would have said adductor canal for this one!

@freestylie Жыл бұрын

Fab video as ever - just wondering what volume you typically use and of what percent ropivicaine and do you use half above and half below. I note Dr Albrecht's recent paper reckoning 37 vs 18mins onset time in his series for intra vs extrafascial supraclaviculars. Ive found longer in my practice although I think might be relying too heavily on motor block onset time rather than distinguishing from sensory block onset time in reckoning surgical readiness? Just wondering your thoughts?

@sleepdoctor09 Жыл бұрын

Could you link the paper, please? Many thanks

@tinuskaaaa Жыл бұрын

Hi guys, thanks for excellent video. If you use for example 30 ml LA, do you add adrenalin to your LA as well? Becasue it looks like a volume block, if you use 30 ml and I mean it as a prevention to LAST. Thx

@regionalanesthesiology 11 ай бұрын

Yes, we always use adrenalin with our local anesthetic when using these big volumes (30-40 ml)…as a way to reduce the peak plasma concentration from the vasoconstriction and also as an intravascular marker. Thanks for watching!!

@Peace-yu6yu Жыл бұрын

can we performe blind supraclavicular block in resource limited areas? if yes what are the techniques that we have to follow? you videos are amaizing ,thank you !

@regionalanesthesiology 10 ай бұрын

We used to do the supraclav approach with nerve stimulation (feel the subclavian pulse right above the clavicle and insert needle immediately lateral, aiming for first rib). There are some that did that approach without stimulation and just aimed to hit the first rib and then inject. So, it certainly CAN be done. However, if it were me in a resource limited environment, I would do an axillary brachial plexus block. It’s very safe, no risk of pneumothorax, effective. The transarterial approach requires just needle, syringe and a short length of tubing. If you have a nerve stimulator, that’s even better and you can elicit a twitch for each of the nerves. Thanks for watching and good luck!!

@johannorozco27 2 жыл бұрын

How do you block Intercostobrachial Nerve?

@riturajbhardwaj9020 Жыл бұрын

By ring block...

@jxij99 10 ай бұрын

is supraclavicular and infraclavicular block coverage different?

@regionalanesthesiology 9 ай бұрын

They are virtually indistinguishable...so the reason for why you'd choose infra vs. supra becomes personal preference, comfort, and sometimes patient factors such as obesity or large pec muscles (which can make infra somewhat challenging) or the presence of arteries in the supraclavicular brachial plexus that might make infraclavicular a safer option. Always good to have multiple arrows in your quiver! 🏹

@jxij99 9 ай бұрын

@@regionalanesthesiology thank you for your insight doc

@SamAndSamuel 7 ай бұрын

Your probe positioning comment is poorly worded. Listen again at 1:55

@namir91 3 ай бұрын

Made perfect sense to me with the video demonstrating what to do

@haliShanna 7 ай бұрын

One thing I would like to mention, which for some reason in all videos are lacking. The depth- ajust the dept 3 cm for average person of 170-180 lb. Introduce the needle paralel to the clavicle and way ( 2 to 3cm) from the transducer. The goal is, the needle not to go toward the pleura and the needle to be visulized better ( paralel to the clavicle means paralel to the US beam and better visualization). Never every advance the needle "blindly". Always have a perfect visualization of the needle, ALWAYS in this block, have your dopler ON. Too many vessels there to take a risk. good luck...