Brachial plexus blocks:

 

Comparison:

 

INTERSCALENE

SUPRACLAVICULAR

INFRACLAVICULAR

AXILLARY

Structure

Trunks

Divisions

Cords

Branches

Hits

Shoulder

Proximal arm

Arm

Elbow

Forearm

±Hand

Elbow

Forearm

Hand

Forearm

Hand

Misses

Entire inferior trunk (C8,T1)

T2

Suprascapular nerve

±Inferior div’n (C8,T1)

  Angle probe caudad

  Aim for corner pocket

T2

Suprascapular nerve

T2

Musculocut nerve (separate)

MCNA

MCNF

LCNF (musculocut)

T2

Whoops

Phrenic (3/3)

-obstructive: not so bad

-restrictive: disaster

SNS (Horner’s)

Vertebral artery

Epidural spread

RLN palsy

Phrenic (2/3)

Pneumothorax

Subclav a, dorsal scap a.

Phrenic (1/3)

Pneumothorax

Nothing really

Position

Semi-recumbent

Head tilted

Semi-recumbent

Head tilted

Supine

Head tilted

Supine

Street protest position

(arm abducted, elbow 90°)

Probe

Straight

Straight

Curved

Straight

 

 

 

Brachial plexus:

Diagram

Description automatically generated

 

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