D'Souza Ryan S., Johnson Rebecca L.
Mayo Clinic, Rochester, Minnesota
The supraclavicular block is a regional anesthetic technique used as an alternative or adjunct to general anesthesia or used for postoperative pain control for upper extremity surgeries (mid-humerus through the hand). First introduced in 1911 by Kulenkampff as a landmark-based approach, the associated risk of pneumothorax was likely responsible for the technique falling out of favor. With the advent of ultrasonography, La Grange described the utilization of the Doppler probe to identify arteries in 1978. Contemporarily, Kapral and colleagues advocated for the dynamic use of ultrasound to guide needle advancement in the supraclavicular position. Colloquially known as the “spinal of the arm,” the supraclavicular block is advantageous as the brachial plexus nerves are tightly packed in this approach and speed of onset is often rapidly achieved. However, because of this consolidated relationship, consider restricting volumes of local anesthesia to as low as possible to achieve goals, as compression ischemia may occur.
锁骨上阻滞是一种区域麻醉技术，可作为全身麻醉的替代方法或辅助手段，也可用于上肢手术（从肱骨中部到手部）的术后疼痛控制。1911年，库伦坎普夫首次将其作为一种基于体表标志的方法引入，气胸相关风险可能是该技术失宠的原因。随着超声技术的出现，1978年拉格朗日描述了使用多普勒探头识别动脉的方法。同时，卡普拉尔及其同事主张动态使用超声引导针在锁骨上位置推进。锁骨上阻滞俗称“手臂的脊髓麻醉”，具有优势，因为在这种方法中臂丛神经紧密聚集，且通常能迅速起效。然而，由于这种紧密的关系，考虑将局部麻醉药的用量限制在尽可能低的水平以达到目的，因为可能会发生压迫性缺血。
