Anatomical study of the brachial plexus using surface ultrasound

Anaesthesia and Intensive Care
C E RoyseA G Royse

Abstract

The aim of this study was to define the anatomy relevant to brachial plexus regional anaesthesia and to identify the extent of variation between individuals. Surface ultrasound examination of the brachial plexus was performed on twenty volunteers. In the axilla there was considerable individual variation in the location of the median, radial and ulnar nerves in relation to the axillary artery. There was often more than one venous structure in this region, which was easily compressed by surface palpation. In the supraclavicular region, neural elements were located inferiorly to the subclavian artery in two volunteers. In one volunteer, a vein was identified between nerve trunks in the interscalene region. These findings indicate that the anatomical variation is considerable, even within the relatively small sample studied. For this reason, use of surface ultrasound may lead to increased success of brachial plexus regional anaesthesia and a decreased risk of intravascular injection.

References

Sep 1, 1989·British Journal of Anaesthesia·P L Ting, V Sivagnanaratnam
Apr 27, 2001·Anesthesia and Analgesia·G RetzlW Mauritz
Oct 23, 2003·Anesthesia and Analgesia·Vincent W S ChanOlusegun Odukoya

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Citations

Jul 18, 2008·Anesthesia and Analgesia·Ki Jinn ChinVincent Chan
May 29, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Paul Soeding, Norman Eizenberg
Mar 27, 2013·Acta Anaesthesiologica Scandinavica·Jadranka Pavičić ŠarićJelena Zenko
Feb 5, 2013·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Marie-Josée NadeauNicolas Dion
Jul 10, 2009·Regional Anesthesia and Pain Medicine·Baskar P Manickam, Richard Brull
Nov 19, 2009·Regional Anesthesia and Pain Medicine·Daniel M WongMichael J Barrington
May 11, 2011·Regional Anesthesia and Pain Medicine·Rajeev SubramanyamRichard Brull
Dec 30, 2016·The Journal of Craniofacial Surgery·Rajani Singh
May 8, 2009·Acta Anaesthesiologica Scandinavica·Z J Koscielniak-NielsenL Hesselbjerg
Feb 27, 2018·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Ahmet AslanAdnan Kabaalioğlu
Nov 19, 2009·Regional Anesthesia and Pain Medicine·Geert J van GeffenGerbrand J Groen
Aug 24, 2020·British Journal of Anaesthesia·Pornpatra AreerukManoj K Karmakar

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