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:
www.nysora.com/techniques/upp...
🖥 Test drive NYSORA's Compendium of Regional Anesthesia: bit.ly/3gsMYdc
00:00 Introduction
00:25 Anatomy
3:14 Technique
5:25 Ending
🖥 Start your 7-day free trial on the NYSORA LMS today and see why it is the go-to resource to master Regional Anesthesia at nysoralms.com
📱 Download the NYSORA Nerve Blocks app
iOS: apple.co/2WUqoi7
Android: bit.ly/NYSORAMApp
Where else to find us:
Web- www.nysora.com
Twitter- / nysora
Instagram- / nysora_community
Facebook- / nysora
TikTok- / nysora_community
---------------------------------------------------------
#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 KZread channel is accurate.
Пікірлер: 77
DO NOT MISS OUT OUR NEW VIDEOS, SUBSCRIBE HERE: kzread.info
Great video. I still remember your teachings back in the days along with Prof Karmakkar in Beijing/HK.
Hvala vam dr Hadžić na svom znanju koje prenosite🤲 Thank you...
Hadzic sir ...u are a ROCKSTAR !!!!! Respect !!
@nysoravideo
Жыл бұрын
Hi Sudipta, Glad to hear this! Thanks!
So simple and so helpful!! Thank you from South Africa!
@nysoravideo
3 жыл бұрын
Glad it was helpful! Thank you!
Use to read nysora's webpage when I was a resident, now I see your videos in KZread as a practitioner. Still dream with living in NY and attend to Nysora. Greetings from México
@nysoravideo
Жыл бұрын
Hi ilopezgMD! So kind of you, and we are really glad you are enjoying our work. Greetings from NYSORA!
U are a legend Thank you so much
Good job Admir , you are a true expert !
@nysoravideo
6 ай бұрын
Thanks!
One of the best video on supraclavicular block. Thank you fro Nigeria
@nysoravideo
Жыл бұрын
Glad it was helpful!
Perfectly explained, thanks a lot
@nysoravideo
2 жыл бұрын
You are welcome!
nice presentation, we always learn from your videos dear Hadmic, you make our job and life easy
@nysoravideo
2 жыл бұрын
Glad to hear that!
Awesome n very simplified video.. Thank you very much Sir.
@nysoravideo
2 жыл бұрын
Hi Sanjavini! Thanks for watching. Do subscribe to this channel as there's more coming up. Greetings from NYSORA!
Great illustration. Thanks
@nysoravideo
3 жыл бұрын
Thank you!
Thank you from an anesthesiologist in Spain 🇪🇸
@nysoravideo
3 жыл бұрын
You're welcome!
Thanks for this clear presentation.
@nysoravideo
Жыл бұрын
Hi Dan, Glad it was helpful!
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.
@nysoravideo
3 жыл бұрын
Thanks for sharing!
Wow such an amazing video clearcut concept 🎉❤
@nysoravideo
Жыл бұрын
Glad you think so!
Many thanks ,very good illustraion
@nysoravideo
3 жыл бұрын
Thank you! Subscribe to the channel, more videos coming soon. For more illustrations like this, you can downoad the NYSORA Nerve blocks mobile app with 300+ illustrations, images and animations. Available on Apple App store or Google play!
Perfect!
Wonderful chanel! Thank you, from Russia :)
@nysoravideo
3 жыл бұрын
Thank you! Greetings to Russia! :)
Great video. Thanks
@nysoravideo
2 жыл бұрын
You are welcome!
Perfectly explained
@nysoravideo
2 жыл бұрын
Hi Dr. kasif Raza! Indeed. Thank you for your comment! Make sure you subscribe to the channel so that you do not miss some super educational upcoming videos!
Nice demonstration.. thank u
@nysoravideo
Жыл бұрын
Glad you liked it
Thank you sir... It's very useful to beginners
@nysoravideo
Жыл бұрын
Hi Vamsi! Thank you for your comment. Keep watching!
Thanks ya for sharing inspiring information experience ♥️♥️♥️♥️♥️♥️♥️♥️♥️♥️♥️
@nysoravideo
2 жыл бұрын
Hey Wafa Ibrahim! Thank you for your comment! Make sure you subscribe to the channel so that you do not miss some super educational upcoming videos!
I love your video tutorials..... It would be helpful if you designated medial and lateral
@nysoravideo
Жыл бұрын
Hi Dave! Noted.
That was awesome
@nysoravideo
3 жыл бұрын
Thank you!
After long years of experience in nerve blocks, I came to a conclusion regarding upper limb blocks which is: out of the 4 approaches to the brachial plexus, you only need to do Interscalene for shoulders and infraclavicular for full arm anesthesia. Forget about the supra clavicle and axillary. By the way the supraclav will miss T2 inteecostobrachial nerve which supply medial arm whereas infra clavicle don’t. Infraclavicular is the true spinal of the upper arm.
Awesome 👏👏👏👏
@nysoravideo
2 жыл бұрын
Thanks!
U are master, Sir Admir hadzic
@nysoravideo
2 жыл бұрын
Hi Jai Kumar! Indeed. Thank you for your comment! Make sure you subscribe to the channel so that you do not miss some super educational upcoming videos!
Thanks a lot
@nysoravideo
Жыл бұрын
Most welcome
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.
awesome.
@nysoravideo
3 жыл бұрын
Thanks!
Very nice video. Do you use the Supraclavicular Block for Carpal Tunnel Releases?
@nicolascrescimone
2 жыл бұрын
No
@AJohnson0325
Жыл бұрын
That would be overkill in my opinion. Most people where I work would just do a general with LMA and let the surgeon localize. These are quick cases but the surgeon uses a tourniquet and the bed will be turned 90 degrees from the anesthesia machine.
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??
I love your video tutorials..... It would be helpful if you designated left and right
@nysoravideo
Жыл бұрын
Noted!
Where do we put the ultrasound probe??
do u recommend needle bevel to be downwards on all blocks? I also do find that the double tip seems to disappear when the bevel is downwards but bevel up seems to be easier during insertion & less painful. or does it only matter in fascial plane blocks when the accuracy of needle tip is of outmost important?
@memongn
2 жыл бұрын
we do puncture site analgesia
@memongn
2 жыл бұрын
needle tip visualization is basic, we dont move under needle cut is that is bevel is under vision
🙏🏻🙏🏻
i just had this done
What do you think about medial aproximation?
♥️👌🏽👌🏽✌🏼👌🏽
I luv u😊
@nysoravideo
8 ай бұрын
We love you back!
This vid is not on the app…the paid app just the 3D anatomy.