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Background and Aims In recent years, the ultrasound-guided costoclavicular brachial plexus block (CCB) has emerged as a novel approach for paediatric anaesthesia, presenting a potentially lower risk profile and effective regional anaesthesia technique. The costoclavicular space is situated between the posterior surface of the middle-third of the clavicle and the anterior chest wall.

Methods This review synthesises existing literature, studies, and clinical cases that focus on the costoclavicular approach. The focus was on paediatric outcomes, evaluating block success rates, analgesic efficacy, incidence of complications, and postoperative pain scores in comparison to traditional techniques like lateral sagittal and supraclavicular blocks.

Results The findings indicate that CCB provides a success rate comparable to traditional methods but with notable advantages including shorter block performance times and faster onset of action. Fewer complications were observed, such as reduced incidents of hemidiaphragm paralysis. The cords of the brachial plexus are superficially positioned within the costoclavicular space and maintain a consistent relation to each other and the axillary artery, facilitating enhanced ultrasound imaging and improved visibility of the needle. These anatomical characteristics have likely played a significant role in the successful implementation of the block. In the case of younger children, to address anatomical hurdles such as the coracoid process obstructing needle entry, it is advisable to employ alternative techniques for needle insertion, such as the medial to lateral approach, ensuring both safe and effective pain management.

Conclusions CCB emerges as a valuable technique for paediatric upper extremity surgeries, providing a safer and effective alternative with shorter procedural times and minimal complications.