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[Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients].

Abstract：

BACKGROUND AND OBJECTIVES:Costoclavicular brachial plexus block is an anesthesia performed through the infraclavicular route described in the literature as a safe and effective route for upper limb anesthesia distal to the elbow. The following report describes the case of a patient whose traditional plexus blocking techniques presented ultrasound visualization difficulty, but the costoclavicular approach was easy to visualize for anesthetic blockade. CASE REPORT:A grade 3 obese patient scheduled for repair of left elbow fracture and dislocation. Ultrasound examination revealed a distorted anatomy of the supraclavicular region and the axillary region with skin lesions, which made it impossible to perform the blockade in these regions. It was decided to perform an infraclavicular plexus block at the costoclavicular space, where the brachial plexus structures are more superficial and closer together, supported by a muscular structure, lateral to all adjacent vascular structures and with full view of the pleura. The anesthetic block was effective to perform the procedure with a single injection and uneventfully. CONCLUSION:Costoclavicular brachial plexus block is a good alternative for upper limb anesthesia distal to the elbow, being a safe and effective option for patients who are obese or have other limitations to the use of other upper limb blocking techniques.

journal_name

Rev Bras Anestesiol

journal_title

Revista brasileira de anestesiologia

authors

Silva GR,Borges DG,Lopes IF,Ruzi RA,Costa PRRM,Mandim BLDS

doi

10.1016/j.bjan.2019.01.004

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

510-513

issue

5

eissn

0034-7094

issn

1806-907X

pii

S0034-7094(18)30457-4

journal_volume

69

pub_type

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