How to Perform a Supraclavicular Brachial Plexus Block

Objective: 

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

Technique:

• The 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