Tips for an Infraclavicular Brachial Plexus Block

The infraclavicular brachial plexus block targets the brachial plexus at the level of the cords (i.e., lateral, medial, and posterior cords) to provide anesthesia for the arm below the shoulder. Developed as an alternative to supraclavicular blocks, this technique significantly minimizes the risk of complications like pneumothorax. The use of ultrasound further reduces the likelihood of complications, making this approach particularly well-suited for catheter use.

Follow these 3 essential steps for a successful infraclavicular brachial plexus block

1. Place the transducer in a sagittal orientation just beneath the clavicle, adjacent to the coracoid process.
2. Move the transducer lateral and medial while applying pressure to locate the fascia of the pectoralis minor muscle and the axillary artery (AA) below it at a depth between 3-5 cm.
3. Insert the needle in-plane, from cephalad to caudal, behind the AA while avoiding the lateral cord, and inject 20-25 mL of local anesthetic. 

Watch the video below to get a better picture of the process and see how the NYSORA Nerve Blocks App brings these instructions to life:

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