Supraclavicular Brachial Plexus Block - a 3-Minute How-to Guide

This 3-minute video outlines how to perform a supraclavicular brachial plexus block. Critical points are as follows:
1. Tilt the probe/beam as needed to obtain a view of the plexus and artery lying on the 1st rib (and not the pleura), and to make the fascial layers and plexus as echogenic as possible.
2. Identify the suprascapular nerve and ensure it is not in the planned needle path.
3. Exclude the presence of vessels, such as the suprascapular artery, in the needle path.
4. Upon piercing the brachial plexus sheath, use incremental hydrodissection to open up and create safe paths for needle advancement
5. Divide the injection between "corner pocket" and the plane between superior & middle trunks for optimal spread and efficacy.

[chandrikakamath]

Your expertise is evident in every video. Thanks for putting up such wonderful demos. Your needle is seen so well. Which needle do you use and could you please give tips on where on the skin the entry point of the block needle should be vis-a-vis the probe ?

[teely]

Dr Chin,
Thank you for the video! How do you ensure nerve protection when injecting between superior and middle trunk if the two is not obviously distinct to our eyes? Your video did describe careful needling and gentle hydrodissection towards the area of interest but does it always prevent subepineural injections as described with the intracluster approach? Many thanks for your reply to this!