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ANALGESIA

Use of Magnetic Resonance Imaging to Define the Anatomical Location Closest to All Three Cords of the Infraclavicular Brachial Plexus

Axel R. Sauter, MD^*, Hans-Jørgen Smith, DMSc, Audun Stubhaug, DMSc^*, Michael S. Dodgson, FRCA, and Øivind Klaastad, DMSc

From the *Department of Anesthesiology, Rikshospitalet (Faculty Division), University of Oslo, Norway; Department of Radiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway; Department of Radiology, University of Oslo, Norway; and Department of Anesthesiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.

Address correspondence and reprint requests to Axel R. Sauter, Department of Anesthesiology, Rikshospitalet University Hospital, 0027 Oslo, Norway. Address e-mail to sauter{at}start.no.

Abstract

Infraclavicular techniques are often used to perform brachial plexus blocks. In our volunteer study we used magnetic resonance imaging to identify the brachial plexus and axillary vessels in a sagittal plane corresponding to the lateral sagittal infraclavicular block. In 20 volunteers, all cords were positioned within 2 cm from the artery approximately within 2/3 of a circle. We derived an injection site that was closest to all cords, cranio-posterior and adjacent to the axillary artery. We conclude that this knowledge may be useful for the performance of infraclavicular blocks aided by ultrasound. However, our proposals should be tested by clinical studies.

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