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Brachial Plexus Block: A Comparison of the Supraclavicular Lateral Paravacular and Axillary Approaches
  1. James W. Fleck, D.O.,
  2. S. S. Moorthy, M.D.,
  3. John Daniel, M.D. and
  4. Stephen F. Dierdorf, M.D.
  1. From the Department of Anesthesia, Indiana University Medical Center, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana
  1. Reprint requests: James W. Fleck, D.O. or S.S. Moorthy, M.D., 1120 South Drive, Fesler Hall 204, Indianapolis, IN 46202-5115.


Background and Objectives. Anesthesia of the brachial plexus has been associated with injuries to adjacent structures (e.g., pneumothorax, vascular penetration). It is not uncommon to have only partial block of the upper extremity, hindering completion of the surgical procedure. The supraclavicular lateral paravascular approach to brachial plexus anesthesia has been proposed as an effective, safe alternative to the traditional approaches to brachial plexus anesthesia.

Methods. This prospective, randomized study sought to determine if the supraclavicular lateral paravascular (SCLP) approach is as effective as the transarterial axillary approach, the most common brachial plexus block used at our institution.

Results. 16/20 (80%) of SCLP blocks were good. 13/20 axillary blocks were good. The success rate with the SCLP approach was 95%. The success rate with the axillary approach was 90%.

Conclusions. The supraclavicular lateral paravascular approach is as effective as the axillary approach.

  • anesthetic techniques
  • regional
  • brachial plexus
  • paravascular
  • axillary

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