Sonosite PX ultrasound system displaying supraclavicular brachial plexus image for regional anesthesia.
Objective: 

Spread of local anaesthetic surrounding the brachial plexus lateral to the subclavian artery and superior to the 1st rib.

Technique:
  • The ultrasound transducer is placed transversely, mid-clavicle within the supraclavicular fossa.
  • The brachial plexus is located lateral to the subclavian artery and superior to the first rib.
  • Ideal ultrasound image of the supraclavicular brachial plexus should include: First rib, subclavian artery, and pleura. A clear delineation between the artery and brachial plexus should be visualised.
  • In-plane needle insertion with a lateral to medial approach.
  • Colour Doppler can be utilised to confirm subclavian artery position along with identification of any vessel anatomical variations.
Patient Positioning:

Supine

Transducers:

L-19, L-15, L-12

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