TY - JOUR T1 - Ultrasound-Guided Supraclavicular Block: Outcome of 510 Consecutive Cases JF - Regional Anesthesia & Pain Medicine JO - Reg Anesth Pain Med SP - 171-176 LP - 171-176 DO - 10.1097/AAP.0b013e31819a3f81 VL - 34 IS - 2 AU - Anahi Perlas AU - Giovanni Lobo AU - Nick Lo AU - Richard Brull AU - Vincent W.S. Chan AU - Reena Karkhanis Y1 - 2009/02/01 UR - http://rapm.bmj.com/content/34/2/171-176.abstract N2 - Introduction: Supraclavicular brachial plexus block provides consistently effective anesthesia to the upper extremity. However, traditional nerve localization techniques may be associated with a high risk of pneumothorax. In the present study, we report block success and clinical outcome data from 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery.Methods: After institutional review board approval, the outcome of 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery was reviewed. Real-time ultrasound guidance was used with a high-frequency linear probe. The neurovascular structures were imaged on short axis, and the needle was inserted using an in-plane technique with either a medial-to-lateral or lateral-to-medial orientation.Results: Five hundred ten ultrasound-guided supraclavicular blocks were performed (50 inpatients, 460 outpatients) by 47 different operators at different levels of training over a 24-month period. Successful surgical anesthesia was achieved in 94.6% of patients after a single attempt; 2.8% required local anesthetic supplementation of a single peripheral nerve territory; and 2.6% received an unplanned general anesthetic. No cases of clinically symptomatic pneumothorax developed. Complications included symptomatic hemidiaphragmatic paresis (1%), Horner syndrome (1%), unintended vascular punctures (0.4%), and transient sensory deficits (0.4%).Conclusions: Ultrasound-guided supraclavicular block is associated with a high rate of successful surgical anesthesia and a low rate of complications and thus may be a safe alternative for both inpatients and outpatients. Severe underlying respiratory disease and coagulopathy should remain a contraindication for this brachial plexus approach. ER -