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Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations
Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782193/ https://www.ncbi.nlm.nih.gov/pubmed/35075423 http://dx.doi.org/10.5812/aapm.120658 |
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author | Kaye, Alan D. Allampalli, Varsha Fisher, Paul Kaye, Aaron J. Tran, Aaron Cornett, Elyse M. Imani, Farnad Edinoff, Amber N. Djalali Motlagh, Soudabeh Urman, Richard D. |
author_facet | Kaye, Alan D. Allampalli, Varsha Fisher, Paul Kaye, Aaron J. Tran, Aaron Cornett, Elyse M. Imani, Farnad Edinoff, Amber N. Djalali Motlagh, Soudabeh Urman, Richard D. |
author_sort | Kaye, Alan D. |
collection | PubMed |
description | Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have quicker onset time, and have lower rates of complications than other approaches (axillary, interscalene, etc.). Ultrasound-guidance is commonly utilized to improve outcomes, limit the need for deep sedation or general anesthesia, and reduce procedural complications. Given the SC and IC approaches are the most common approaches for brachial plexus blocks, the differences between the two have been critically evaluated in the present manuscript. Various studies have demonstrated slight favorability towards the IC approach from the standpoint of complications and safety. Two prospective RCTs found a higher incidence of complications in the SC approach – particularly Horner syndrome. The IC method appears to support a greater block distribution as well. Overall, both SC and IC brachial plexus nerve block approaches are the most effective and safe approaches, particularly under ultrasound-guidance. Given the success of the supraclavicular and infraclavicular blocks, these techniques are an important skill set for the anesthesiologist for intraoperative anesthesia and postoperative analgesia. |
format | Online Article Text |
id | pubmed-8782193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-87821932022-01-23 Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations Kaye, Alan D. Allampalli, Varsha Fisher, Paul Kaye, Aaron J. Tran, Aaron Cornett, Elyse M. Imani, Farnad Edinoff, Amber N. Djalali Motlagh, Soudabeh Urman, Richard D. Anesth Pain Med Review Article Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have quicker onset time, and have lower rates of complications than other approaches (axillary, interscalene, etc.). Ultrasound-guidance is commonly utilized to improve outcomes, limit the need for deep sedation or general anesthesia, and reduce procedural complications. Given the SC and IC approaches are the most common approaches for brachial plexus blocks, the differences between the two have been critically evaluated in the present manuscript. Various studies have demonstrated slight favorability towards the IC approach from the standpoint of complications and safety. Two prospective RCTs found a higher incidence of complications in the SC approach – particularly Horner syndrome. The IC method appears to support a greater block distribution as well. Overall, both SC and IC brachial plexus nerve block approaches are the most effective and safe approaches, particularly under ultrasound-guidance. Given the success of the supraclavicular and infraclavicular blocks, these techniques are an important skill set for the anesthesiologist for intraoperative anesthesia and postoperative analgesia. Kowsar 2021-10-31 /pmc/articles/PMC8782193/ /pubmed/35075423 http://dx.doi.org/10.5812/aapm.120658 Text en Copyright © 2021, Author(s) https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. |
spellingShingle | Review Article Kaye, Alan D. Allampalli, Varsha Fisher, Paul Kaye, Aaron J. Tran, Aaron Cornett, Elyse M. Imani, Farnad Edinoff, Amber N. Djalali Motlagh, Soudabeh Urman, Richard D. Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations |
title | Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations |
title_full | Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations |
title_fullStr | Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations |
title_full_unstemmed | Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations |
title_short | Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations |
title_sort | supraclavicular vs. infraclavicular brachial plexus nerve blocks: clinical, pharmacological, and anatomical considerations |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782193/ https://www.ncbi.nlm.nih.gov/pubmed/35075423 http://dx.doi.org/10.5812/aapm.120658 |
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