Infraclavicular Nerve Block

The infraclavicular block is a brachial plexus block used as an alternative or adjunct to general anesthesia. It can be used for postoperative pain control for upper extremity surgeries such as the elbow, forearm, and hand, but not the shoulder. The infraclavicular block is a regional anesthetic technique developed to avoid the side effects and complications of supraclavicular blocks, particularly pneumothorax. The infraclavicular block is a regional anesthetic technique designed to prevent the side effects and complications of supraclavicular blocks, particularly pneumothorax. The advantage of an infraclavicular block is decreased complications with ultrasound, and it is ideally suited for catheter usage. The disadvantage is that the brachial plexus is located deeper and the angle of approach is more acute making visualization of the anatomy and handling a needle at the same time challenging unless the healthcare professional is experienced in performing the procedure. The procedure is also challenging in patients with obesity for these same reasons. Bazy first described the infraclavicular block in 1914, and Speigel described the infraclavicular trans-pectoral perivascular technique in 1967. Raj modified the technique and reported a new approach with higher success rates using a nerve stimulator in 1973. Sims developed the lateral infraclavicular block in 1976 to present a more consistent performance with a constant landmark: the coracoid process. Many approaches have been described since that time, but the most frequent approach today is a sagittal scan at the lateral infraclavicular fossa (LICF).