Subclavicular nerve block question

[Mike1228]

---

Members don't see this ad.

Hey everyone,

I'm on a block rotation and have a question that I can't seem to get a straight answer to. On supraclavicular blocks, the text book calls it a "Trunk" level block but when placing the transducer behind the clavicle (showing 1st rib, pleura, and SC artery) the brachial plexus seems (to me) to be displayed as a "Division" level while described as "grape cluster-like". I thought we'd wanna block at the trunk level because it's the most compact....Are we blocking at the trunk or Division level for supraclavicular block?...and does that mean that interscalene block is actually a trunk level block and not Root level?
Maybe it's a dumb question, but the textbook description doesn't match real life obviously lol....thanks

 

[vector2]

Interscalene - trunks
Supraclav - divisions
Infraclav - cords
Axillary - branches

 

[Blockit]

The brachial plexus doesn’t have strict “property lines”. Depending on the individual’s anatomy you may be at root level OR trunk level when doing an interscalene. Supraclavicular is likely to be between trunk and division level. Once below the clavicle, there is general agreement that you are at cord level.

 

[dhb]

Anatomically correct doesn't mean your block will always work...

 

[deleted126335]

Interscalene - trunks
Supraclav - divisions
Infraclav - cords
Axillary - branches

Tom Drinks Cold Beer.