Regional Anaesthesia

Supraclavicular block is a regional anaesthetic technique used as an alternative or in combination with general anaesthesia.

For upper extremity surgeries [mid humerus through the hand] as well as to provide postoperative analgesia to patient.

It is also known as the spinal of arm, the Supraclavicular block is advantageous as the branchial plexus nerves are tightly packed in this approach and speed of onset is often rapidly achieved.


After taking the written informed consent patient is placed in spine position with arms by the sides.

Baseline intel parameters are taken and in line started. Patient’s head is turned towards contralateral side with head and elevation of 300 mild sedation off needed can also be given. Aseptic technique is used. After preparing skin with povidine iodine solution, desired area is dropped using strile sheets. Sterile conduction gel is applied to USG probe. And use of a sterile probe cover id recommended.

USG probe cover is recommended and Supraclavicular fossa in transuerse position parallel to clavicle and brachial plexus and subclavian arlery are visualized.

First rib appears as hyperechoic line. Using in line approach, needle is advanced from lateral to medial till it reaches neural cluster of brachial plexus. Offer negative aspiration, local anaesthetic is injected. Injection should be stopped if the patient complaints of paresthesia or pain. Nerve stimulator can also be used as an adjunct to ultrasound. The nerve stimulator must be connected before local anaesthetic injection. With contraction of the arm, forearm, wrist occurs below ouma intraneural needle position may be likely and the needle should be withdrawn and redirected.

General complication of Supraclavicular blocks includes risk of injection bleeding neuropathy.

With the advent of USG, constant visualization of the needle tip rib, plevra can decrease the risk for pneumothorax common, self-limited side effects associated with Supraclavicular block include hoarseness due to an ipsilateral laryngeal nerve block Horner syndrome from stellate ganglion block and hemi diaphragmatic paresis form phrenic nerve blockage. Local anaesthetic systemic toxicity is also possible.

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