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. Infraclavicular Brachial Plexus Block. The Internet Journal of Pain, Symptom Control and Palliative Care. 2000 Volume 1 Number 2.
With the patient in the supine position, the block is best performed with the arm abducted at 90° angle and the patient’s head facing away from the arm to be anesthetized (Figure 1).
The following anatomical landmarks are identified and marked:
The anesthesiologist stands at the opposite site to be blocked. The needle is inserted 2 cm below the midpoint of the clavicle and directed toward the axillary artery (Figures 2,3,4).
With this approach, the needle commonly assumes an angle of 60° to the skin plane. The needle is slowly advanced until the twitches from hand or forearm are obtained (Figure 5).
The initial current of 0.6-0.8 mAmps is decreased to below 0.3 mAmps at which point 40 -50 ml of local anesthetic is injected (Figure 6).