Use of Magnetic Resonance Imaging to Define the Anatomical Location Closest to All Three Cords of the Infraclavicular Brachial Plexus

Infraclavicular techniques are often used to perform brachial plexus blocks. In our volunteer study we used magnetic resonance imaging to identify the brachial plexus and axillary vessels in a sagittal plane corresponding to the lateral sagittal infraclavicular block. In 20 volunteers, all cords were positioned within 2 cm from the artery approximately within 2/3 of a circle. We derived an injection site that was closest to all cords, cranio-posterior and adjacent to the axillary artery. We conclude that this knowledge may be useful for the performance of infraclavicular blocks aided by ultrasound. However, our proposals should be tested by clinical studies.

[1]  Z. Koscielniak-Nielsen,et al.  Clinical Evaluation of the Lateral Sagittal Infraclavicular Block Developed by MRI Studies , 2005, Regional Anesthesia & Pain Medicine.

[2]  Örjan Smedby,et al.  A Novel Infraclavicular Brachial Plexus Block: The Lateral and Sagittal Technique, Developed by Magnetic Resonance Imaging Studies , 2004, Anesthesia and analgesia.

[3]  S. Mackey,et al.  Ultrasound imaging of the axillary vein--anatomical basis for central venous access. , 2004, British journal of anaesthesia.

[4]  V. Chan,et al.  Brachial Plexus Examination and Localization Using Ultrasound and Electrical Stimulation: A Volunteer Study , 2003, Anesthesiology.

[5]  F. Bonnet,et al.  A Comparison of a Single-Stimulation Lateral Infraclavicular Plexus Block With a Triple-stimulation Axillary Block , 2003, Regional Anesthesia & Pain Medicine.

[6]  A. Borgeat,et al.  Ultrasound-guided infraclavicular brachial plexus block. , 2003, British journal of anaesthesia.

[7]  D. Sheppard,et al.  Editorial I Ultrasound‐guided nerve blocks , 2002 .

[8]  D. Sheppard,et al.  Ultrasound-guided nerve blocks. , 2002, British journal of anaesthesia.

[9]  C. Dumont,et al.  An evaluation of the infraclavicular block via a modified approach of the Raj technique. , 2001, Anesthesia and analgesia.

[10]  C. Ootaki,et al.  Ultrasound-Guided Infraclavicular Brachial Plexus Block: An Alternative Technique to Anatomical Landmark-Guided Approaches , 2000, Regional Anesthesia & Pain Medicine.

[11]  Z. Koscielniak-Nielsen,et al.  Comparison of transarterial and multiple nerve stimulation techniques for an initial axillary block by 45 mL of mepivacaine 1% with adrenaline , 1998, Acta anaesthesiologica Scandinavica.

[12]  P. Geiger,et al.  [Infraclavicular vertical brachial plexus blockade. A new method for anesthesia of the upper extremity. An anatomical and clinical study]. , 1995, Der Anaesthesist.

[13]  H. Mehrkens,et al.  Die vertikale infraklavikuläre Blockade des Plexus brachialis Eine neue Methode zur Anästhesie der oberen Extremität , 1995, Der Anaesthesist.