Supraclavicular Brachial Plexus Block a 3 Minute How to Guide

This 3minute 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. See the excellent video by Dr Jeff Gadsden at Duke Anesthesiology for more details and clinical pearls. Also see my accompanying video demonstrating catheter insertion using a slightly different approach