supraclavicular การใช้

• The first percutaneous supraclavicular block was performed in 1911 by German surgeon Diedrich Kulenkampff ( 18801967 ).
• Brachial plexus anesthesia by percutaneous injection through axillary and supraclavicular approaches was developed in the early 20th century.
• The neck and supraclavicular fossa are palpated to feel for cervical adenopathy, other masses, and laryngeal crepitus.
• This is because the supraclavicular nerves have the same cervical nerves origin as the phrenic nerve, C3 and C4.
• For supraclavicular block, nerve stimulation with a minimal threshold of 0.9 mA can offer a dependable block.
• The ipsilateral supraclavicular fossa is compressed again and any change in CVP value and / or its waveform pattern is noted.
• However, the supraclavicular block is often quicker to perform and may result in fewer side effects than the interscalene block.
• Complications associated with interscalene and supraclavicular blocks include inadvertent epidural injection of local anesthetic, which can result in respiratory failure.
• Another concept is that one of the supraclavicular nodes corresponds to the end node along the thoracic duct and hence the enlargement.
• There is some evidence to suggest that the use of ultrasound guidance in combination with nerve stimulation can shorten the performance time of supraclavicular block.
• He secured a needle in the supraclavicular fossa and attached tubing connected to a syringe through which he could inject incremental doses of local anesthetic.
• Compared to the interscalene block, the supraclavicular block  despite eliciting a more complete block of the musculocutaneous nerves  does not improve postoperative analgesia.
• Unlike the interscalene block  which results in diaphragmatic hemiparesis in all subjects  only half of those who undergo supraclavicular block experience this side effect.
• The supraclavicular flap, also known as the " epaulette " flap is vascularized by the surpaclavicular artery, which branches off the transverse cervical artery.
• It is covered, in front, by the skin, the superficial fascia, the Platysma, the supraclavicular nerves, and the deep cervical fascia.
• Similarly, an enlarged right supraclavicular lymph node tends to drain thoracic malignancies such as lung and esophageal cancer, as well as Hodgkin's lymphoma.
• Following successful puncture of subclavian vein with a cannula / needle, same side of IJV is compressed externally by placing a sterile finger in supraclavicular fossa.
• Compared to the infraclavicular block and axillary blocks, the successful achievement of adequate anesthesia for surgery of the upper extremity is about the same with supraclavicular block.
• There are multiple approaches to blockade of the brachial plexus, beginning proximally with the interscalene block and continuing distally with the supraclavicular, infraclavicular, and axillary blocks.
• Disadvantages of the supraclavicular block include the risk of pneumothorax, which is estimated to be between 1 % 4 % when using paresthesia or peripheral nerve stimulator guided techniques.