Skip to main content
Top
Published in: Journal of Anesthesia 1/2012

01-02-2012 | Clinical Report

Failure of supraclavicular block under ultrasound guidance: clinical relevance of anatomical variation of cervical vessels

Authors: Sakura Kinjo, Aaron Frankel

Published in: Journal of Anesthesia | Issue 1/2012

Login to get access

Abstract

We describe a case with partial analgesia after ultrasound-guided supraclavicular block for elbow surgery. The failure of the block was caused by the limited spread of local anesthetic because of blockage by a vessel (either transverse cervical artery or dorsal scapular artery) running through the brachial plexus. Anesthesiologists should be aware that cervical anatomy is complex and has anatomical variations. Thus, careful ultrasound screening of anatomical structure, especially using color Doppler, is important in performing brachial plexus block.
Literature
1.
go back to reference Liu SS, Gordon MA, Shaw PM, Wilfred S, Shetty T, Yadeau JT. A prospective clinical registry of ultrasound-guided regional anesthesia for ambulatory shoulder surgery. Anesth Analg. 2010;111:617–23.CrossRefPubMed Liu SS, Gordon MA, Shaw PM, Wilfred S, Shetty T, Yadeau JT. A prospective clinical registry of ultrasound-guided regional anesthesia for ambulatory shoulder surgery. Anesth Analg. 2010;111:617–23.CrossRefPubMed
4.
go back to reference Perlas A, Lobo G, Lo N, Brull R, Chan VW, Karkhanis R. Ultrasound-guided supraclavicular block: outcome of 510 consecutive cases. Reg Anesth Pain Med. 2009;34:171–6.CrossRefPubMed Perlas A, Lobo G, Lo N, Brull R, Chan VW, Karkhanis R. Ultrasound-guided supraclavicular block: outcome of 510 consecutive cases. Reg Anesth Pain Med. 2009;34:171–6.CrossRefPubMed
5.
go back to reference Abrahams MS, Panzer O, Atchabahian A, Horn JL, Brown AR. Case report: limitation of local anesthetic spread during ultrasound-guided interscalene block. Description of an anatomic variant with clinical correlation. Reg Anesth Pain Med. 2008;33:357–9.PubMed Abrahams MS, Panzer O, Atchabahian A, Horn JL, Brown AR. Case report: limitation of local anesthetic spread during ultrasound-guided interscalene block. Description of an anatomic variant with clinical correlation. Reg Anesth Pain Med. 2008;33:357–9.PubMed
6.
go back to reference Sites BD, Macfarlane AJ, Sites VR, Naraghi AM, Chan VW, Antonakakis JG, Singh M, Brull R. Clinical sonopathology for the regional anesthesiologist: part 1: vascular and neural. Reg Anesth Pain Med. 2010;35:272–80.CrossRefPubMed Sites BD, Macfarlane AJ, Sites VR, Naraghi AM, Chan VW, Antonakakis JG, Singh M, Brull R. Clinical sonopathology for the regional anesthesiologist: part 1: vascular and neural. Reg Anesth Pain Med. 2010;35:272–80.CrossRefPubMed
7.
go back to reference Chen WL, Zhang DM, Yang ZH, Huang ZQ, Wang JG, Zhang B, Li JS. Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation. J Oral Maxillofac Surg. 2010;68:2422–30.CrossRefPubMed Chen WL, Zhang DM, Yang ZH, Huang ZQ, Wang JG, Zhang B, Li JS. Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation. J Oral Maxillofac Surg. 2010;68:2422–30.CrossRefPubMed
8.
go back to reference Aggarwal A, Puri N, Aggarwal AK, Harjeet K, Sahni D. Anatomical variation in formation of brachial plexus and its branching. Surg Radiol Anat. 2010;32:891–4.CrossRefPubMed Aggarwal A, Puri N, Aggarwal AK, Harjeet K, Sahni D. Anatomical variation in formation of brachial plexus and its branching. Surg Radiol Anat. 2010;32:891–4.CrossRefPubMed
9.
go back to reference Reiner A, Kasser R. Relative frequency of a subclavian vs a transverse cervical origin for the dorsal scapular artery in humans. Anat Rec. 1996;244:265–8.CrossRef Reiner A, Kasser R. Relative frequency of a subclavian vs a transverse cervical origin for the dorsal scapular artery in humans. Anat Rec. 1996;244:265–8.CrossRef
Metadata
Title
Failure of supraclavicular block under ultrasound guidance: clinical relevance of anatomical variation of cervical vessels
Authors
Sakura Kinjo
Aaron Frankel
Publication date
01-02-2012
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 1/2012
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-011-1252-y

Other articles of this Issue 1/2012

Journal of Anesthesia 1/2012 Go to the issue