Supraclavicular Block - Regional anesthesia Crash course with Dr. Hadzic

The supraclavicular block is one of several techniques used to anesthetize the brachial plexus. The block is performed at the level of the brachial plexus trunks where almost the entire sensory, motor, and sympathetic innervation of the upper extremity is carried in just three nerve structures confined to a very small surface area. Consequently, this technique typically provides a predictable, dense block with rapid onset. In 1911, Georg Hirschel described a surgical approach to the brachial plexus in the axilla. A few months later, Diedrich Kulenkampff, in Germany, performed the first percutaneous supraclavicular approach, reportedly on himself. The technique was published in 1928 by Kulenkampff and Persky. As they described it, the technique was performed with the patient in the sitting position (“a regular chair will suffice”) or in the supine position with a pillow between the shoulders. The operator sat on a stool at the side of the patient. The needle was inserted above the midpoint of the clavicle where the pulse of the subclavian artery could be felt and was directed medially toward the spinous process of T2 or T3. Kulenkampff ‘s familiarity with brachial plexus anatomy allowed him to recognize that “the best way to reach the trunks was in the neighborhood of the subclavian artery over the first rib.” His technique was also simple: “all the branches of the plexus could be anesthetized through one injection.” These two assertions are still valid today. Unfortunately. his advice on needle direction carried an inherently high risk of pneumothorax. The popularity of the supraclavicular block remained unrivaled during the entire first half of the 20th century until well after World War II. During this time the technique underwent several modifications, most of them intended to reduce the risk of pneumothorax. The introduction of axillary techniques by Accardo and Adriani in 1949 and by Burnham10 in 1958 marked the beginning of the decline in enthusiasm for the supraclavicular block.

Supraclavicular Brachial Plexus Block – Landmarks and Nerve Stimulator Technique:

00:00 Introduction
00:25 Anatomy
3:14 Technique
5:25 Ending

📱 Download the NYSORA Nerve Blocks app

Where else to find us:

---------------------------------------------------------
#nysora #regionalanesthesia #anesthesia

Disclaimer:
Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Youtube channel is accurate.

[sallehasamad]

Great video. I still remember your teachings back in the days along with Prof Karmakkar in Beijing/HK.

[ilopezgMD]

Use to read nysora's webpage when I was a resident, now I see your videos in YouTube as a practitioner. Still dream with living in NY and attend to Nysora. Greetings from México

[sudiptaandroid]

Hadzic sir ...u are a ROCKSTAR Respect !!

[phillipbguerra]

Thank you from an anesthesiologist in Spain 🇪🇸

[memongn]

nice presentation, we always learn from your videos dear Hadmic, you make our job and life easy

[brachialplexus]

One of the best video on supraclavicular block. Thank you fro Nigeria

[jelenakotaran]

Hvala vam dr Hadžić na svom znanju koje prenosite🤲 Thank you...

[davelorenz]

I love your video It would be helpful if you designated medial and lateral

[sribalaji]

Wow such an amazing video clearcut concept 🎉❤

[marisabotes]

So simple and so helpful!! Thank you from South Africa!

[zakalobi]

Great illustration. I think second injection above the upper trunk is as good. sometimes, I inject at the level of divisions. Thank you for sharing that.

[wafaibrahim]

Thanks ya for sharing inspiring information experience ♥️♥️♥️♥️♥️♥️♥️♥️♥️♥️♥️

[jacobbelenky]

Good job Admir, you are a true expert !

[Glubbi]

What I miss in these videos is often the practicsl approach, like where exactly to position the US probe and how to procede in order to even get that image. Then the restbof this video is really great.

[Manatelugu_]

Thank you sir... It's very useful to beginners

[haliShanna]

One don't need to inject LA inside the sheet. Instead, you shot between the 1st rib and the sheet and the 2nd shot is above the sheet, you kinda sandwich the plexus between eh two shots. Done it and worked oerfectly.

[zerofull]

Buenas noches, mi duda es cuanto es la cantidad de lanestesico local debo administrar hablando de lidocaina al 2%, e visto comentarios de que se administra hasta 20 ml pero estos son diluidos en solución salina o son puramente lidocaina?

[संजीवनीविटा-दण]

Awesome n very simplified video.. Thank you very much Sir.

[chillnotb]

Wonderful chanel! Thank you, from Russia :)

[SamtaniPradeep]

Sir how to cover posterior cutaneous nerve of arm which is site of incision in distal humerus or elbow surgery which is frequently spared in this block??