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Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-

BACKGROUND: Magnetic resonance neurography shows the brachial plexus cords in the subcoracoid tunnel beneath the pectoralis minor. With an ultrasound scan along the brachial line, the brachial plexus cords in the subcoracoid tunnel can be targeted using an in-plane needle approach. We describe this...

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Autores principales: Diwan, Sandeep, Sethi, Divya, Gaikwad, Avinash, Sancheti, Parag, Nair, Abhijit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Anesthesiologists 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533173/
https://www.ncbi.nlm.nih.gov/pubmed/32773725
http://dx.doi.org/10.4097/kja.20372
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author Diwan, Sandeep
Sethi, Divya
Gaikwad, Avinash
Sancheti, Parag
Nair, Abhijit
author_facet Diwan, Sandeep
Sethi, Divya
Gaikwad, Avinash
Sancheti, Parag
Nair, Abhijit
author_sort Diwan, Sandeep
collection PubMed
description BACKGROUND: Magnetic resonance neurography shows the brachial plexus cords in the subcoracoid tunnel beneath the pectoralis minor. With an ultrasound scan along the brachial line, the brachial plexus cords in the subcoracoid tunnel can be targeted using an in-plane needle approach. We describe this new approach to the infraclavicular block called the “subcoracoid tunnel block.” CASE: Twenty patients were administered with the ultrasound-guided subcoracoid tunnel block for the below-elbow surgery. The contact of the needle tip with cords was visible in all 20 patients. With neurostimulation, the posterior cord was identified in 11 (55%) and medial cord in 9 (45%) patients on the first needle pass. The subcoracoid tunnel block was successful in 16 patients (80%). CONCLUSIONS: Our case series shows that the subcoracoid tunnel block is an excellent alternative technique for the infraclavicular block. Its advantages include better needle-cord visibility and easy identification of the brachial plexus cords.
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spelling pubmed-75331732020-10-13 Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series- Diwan, Sandeep Sethi, Divya Gaikwad, Avinash Sancheti, Parag Nair, Abhijit Korean J Anesthesiol Case Report BACKGROUND: Magnetic resonance neurography shows the brachial plexus cords in the subcoracoid tunnel beneath the pectoralis minor. With an ultrasound scan along the brachial line, the brachial plexus cords in the subcoracoid tunnel can be targeted using an in-plane needle approach. We describe this new approach to the infraclavicular block called the “subcoracoid tunnel block.” CASE: Twenty patients were administered with the ultrasound-guided subcoracoid tunnel block for the below-elbow surgery. The contact of the needle tip with cords was visible in all 20 patients. With neurostimulation, the posterior cord was identified in 11 (55%) and medial cord in 9 (45%) patients on the first needle pass. The subcoracoid tunnel block was successful in 16 patients (80%). CONCLUSIONS: Our case series shows that the subcoracoid tunnel block is an excellent alternative technique for the infraclavicular block. Its advantages include better needle-cord visibility and easy identification of the brachial plexus cords. Korean Society of Anesthesiologists 2020-10 2020-08-10 /pmc/articles/PMC7533173/ /pubmed/32773725 http://dx.doi.org/10.4097/kja.20372 Text en Copyright © The Korean Society of Anesthesiologists, 2020 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Diwan, Sandeep
Sethi, Divya
Gaikwad, Avinash
Sancheti, Parag
Nair, Abhijit
Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
title Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
title_full Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
title_fullStr Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
title_full_unstemmed Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
title_short Subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
title_sort subcoracoid tunnel block as an alternative infraclavicular brachial plexus approach -a case series-
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533173/
https://www.ncbi.nlm.nih.gov/pubmed/32773725
http://dx.doi.org/10.4097/kja.20372
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