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A novel infraclavicular brachial plexus block: The lateral and sagittal technique, developed by magnetic resonance imaging studies
Department of Anesthesiology, Rikshospitalet University Hospital, Oslo, Norway.
Department of Radiology, Rikshospitalet University Hospital, Oslo, Norway.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-7750-1917
Department of Radiology, Rikshospitalet University Hospital, Oslo, Norway.
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2004 (English)In: Anesthesia and Analgesia, ISSN 0003-2999, E-ISSN 1526-7598, Vol. 98, no 1, 252-256 p.Article in journal (Refereed) Published
Abstract [en]

A new infraclavicular brachial plexus block method has the patient supine with an adducted arm. The target is any of the three cords behind the pectoralis minor muscle. The point of needle insertion is the intersection between the clavicle and the coracoid process. The needle is advanced 0degrees-30degrees posterior, always strictly in the sagittal plane next to the coracoid process while abutting the antero-inferior edge of the clavicle. We tested the new method using magnetic resonance imaging (MRI) in 20 adult volunteers, without inserting a needle. Combining 2 simulated needle directions by 15degrees posterior and 0degrees in the images of the volunteers, at least one cord in 19 of 20 volunteers was contacted. This occurred within a needle depth of 6.5 cm. In the sagittal plane of the method the shortest depth to the pleura among all volunteers was 7.5 cm. The MRI study indicates that the new infraclavicular technique may be efficient in reaching a cord of the brachial plexus, often not demanding more than two needle directions. The risk of pneumothorax should be minimal because the needle is inserted no deeper than 6.5 cm. However, this needs to be confirmed by a clinical study.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2004. Vol. 98, no 1, 252-256 p.
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-46319DOI: 10.1213/01.ANE.0000094337.75996.AEISI: 000187561400059OAI: oai:DiVA.org:liu-46319DiVA: diva2:267215
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2015-03-13Bibliographically approved

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Smedby, Örjan

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Faculty of Health SciencesRadiologyDepartment of Radiology in LinköpingCenter for Medical Image Science and Visualization (CMIV)
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Radiology, Nuclear Medicine and Medical Imaging

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