Early Detection of Intravascular Injection During Ultrasound-Guided Supraclavicular Brachial Plexus Block | Semantic Scholar (2024)

A case of accidental intravascular injection of local anesthetic during infraclavicular brachial plexus block is reported, in spite of the use of ultrasound guidance technique, and negative aspiration for blood.

A case of accidental intravascular injection of local anesthetic during infraclavicular brachial plexus block is reported, in spite of the use of ultrasound guidance technique, and negative aspiration for blood.

The supraclavicular block can provide rapid onset, dense anesthesia of the arm with a single injection, but despite modifications to the original method by Kulenkampff the major disadvantage of these ‘blind’ approaches remains the small but significant risk of pneumothorax.

Based on the anatomic course of the saphenous nerve, it is suggested that this nerve can also be blocked slightly more proximally in the thigh when using ultrasound guidance, where it is situated in close proximity to the femoral artery and deep to the sartorius muscle.

A rare complication of RLN block is discussed which occurred while performing a supraclavicular perivascular block performed under USG guidance, which may conversely create a false sense of security.

A case of bupivacaine systemic toxicity in which successful resuscitation may have been aided by the very early administration of lipid emulsion, in conjunction with effective CPR is presented, adding credence to the value of lipidEmulsion for rescue from local anesthetic systemic toxicity and suggests the need for further study to determine the optimal timing of its administration.

A case of bupivacaine systemic toxicity in which successful resuscitation may have been aided by the very early administration of lipid emulsion, in conjunction with effective CPR is presented, adding credence to the value of lipidEmulsion for rescue from local anesthetic systemic toxicity and suggests the need for further study to determine the optimal timing of its administration.

A case of bupivacaine systemic toxicity in which successful resuscitation may have been aided by the very early administration of lipid emulsion, in conjunction with effective CPR is presented, adding credence to the value of lipidEmulsion for rescue from local anesthetic systemic toxicity and suggests the need for further study to determine the optimal timing of its administration.

It is believed that the reason for a better block would not be because the posterior cord is located deepest at the infraclavicular region, but because of even spread of local anesthetic around it.

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Once accurately positioning the needle in plane (aligned) o the ultrasound beam’s longitudinal axis, one is able to iew the entire needle during its trajectory and then confirm the nerve”s dentity using an optimal nerve stimulation threshold 0.4-0.5 mA (Fig 1).