Distorted supraclavicular brachial plexus anatomy due to cervical rib with a knuckle-usefulness of ultrasound in planning a regional anaesthesia strategy

On scanning of the right side of neck, the bunch of grapes could be identified in the usual position posterolateral to the SCA [Figure 1]b. The patient was informed that the supraclavicular anatomy was not clear and performing an axillary brachial plexus block was an alternative. [...]an axillary br...

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Bibliographic Details
Published in:Indian journal of anaesthesia 2020-02, Vol.64 (2), p.165-167, Article 165
Main Authors: Sripriya, R, Sivashanmugam, T, Ravishankar, M
Format: Article
Language:English
Subjects:
Anesthesia
Brachial plexus
Consent
Fracture repair
Grapes
Internal fixation
Letters to Editor
Patients
Ultrasonic imaging
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Summary:On scanning of the right side of neck, the bunch of grapes could be identified in the usual position posterolateral to the SCA [Figure 1]b. The patient was informed that the supraclavicular anatomy was not clear and performing an axillary brachial plexus block was an alternative. [...]an axillary brachial plexus block was performed. The targeted intracluster approach or multipoint subfascial injection technique, which is commonly used to block the BP at this level, causes an increase in diameter and volume of the clusters and in the presence of mechanical constraint has the possibility of inciting an ischemic injury.
ISSN:0019-5049
0976-2817
DOI:10.4103/ija.IJA_718_19