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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.

Authors+Show Affiliations

Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil. Electronic address: grazielle.rs@gmail.com.Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil.Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil.Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil.Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil.Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil.

Pub Type(s)

English Abstract
Journal Article

Language

por

PubMed ID

31519300

Citation

Silva, Grazielle Rodrigues, et al. "[Ultrasound-guided Costoclavicular Block as an Alternative for Upper Limb Anesthesia in Obese Patients]." Revista Brasileira De Anestesiologia, 2019.
Silva GR, Borges DG, Lopes IF, et al. [Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients]. Rev Bras Anestesiol. 2019.
Silva, G. R., Borges, D. G., Lopes, I. F., Ruzi, R. A., Costa, P. R. R. M., & Mandim, B. L. D. S. (2019). [Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients]. Revista Brasileira De Anestesiologia, doi:10.1016/j.bjan.2019.01.004.
Silva GR, et al. [Ultrasound-guided Costoclavicular Block as an Alternative for Upper Limb Anesthesia in Obese Patients]. Rev Bras Anestesiol. 2019 Sep 10; PubMed PMID: 31519300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients]. AU - Silva,Grazielle Rodrigues, AU - Borges,Danielle Gonçalves, AU - Lopes,Iuri Ferreira, AU - Ruzi,Roberto Araújo, AU - Costa,Paulo Ricardo Rabello de Macedo, AU - Mandim,Beatriz Lemos da Silva, Y1 - 2019/09/10/ PY - 2018/09/29/received PY - 2019/01/02/revised PY - 2019/01/14/accepted PY - 2019/9/15/entrez KW - Anestesia regional KW - Bloqueio do plexo braquial KW - Brachial plexus block KW - Costoclavicular KW - Obesidade KW - Obesity KW - Regional anesthesia KW - Ultrasound KW - Ultrassonografia JF - Revista brasileira de anestesiologia JO - Rev Bras Anestesiol N2 - 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. SN - 1806-907X UR - https://www.unboundmedicine.com/medline/citation/31519300/[Ultrasound-guided_costoclavicular_block_as_an_alternative_for_upper_limb_anesthesia_in_obese_patients] L2 - https://linkinghub.elsevier.com/retrieve/pii/S0034-7094(18)30457-4 DB - PRIME DP - Unbound Medicine ER -