Department of Anesthesia, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
Department of Ophthalmology, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2023 Jul 14;29:e939920. doi: 10.12659/MSM.939920.
In recent years, ultrasound-guided costoclavicular brachial plexus block (CCB) has gained attention as a novel approach for brachial plexus nerve block. Human anatomy studies have identified the costoclavicular space as the area between the midpoint of the clavicle and the first rib. This space accommodates the brachial plexus, axillary arteries, and veins. Its superficial and fixed position makes it a promising option for infraclavicular brachial plexus blockage, providing a safe and reliable analgesic effect. CCB combines the benefits of real-time ultrasound visualization of the nerve block needle, avoidance of peripheral blood vessels, and targeted delivery of local anesthetics to the nerve. Consequently, it significantly reduces the associated complications of other classical approaches such as interscalene brachial plexus block (ISB), supraclavicular brachial plexus block (SCB), lateral sagittal infraclavicular brachial plexus block (LS-ICB), and axillary brachial plexus block. These complications include phrenic paralysis, incomplete brachial plexus block, and pneumothorax. This narrative review examines the literature on brachial plexus block in the costoclavicular space, discussing the anatomical position, the procedure, clinical indications, choice of local anesthetic concentration and volume, and continuous nerve block of CCB. The aim is to provide a basis for future clinical practice and enhanced safety.
近年来，超声引导下锁骨下臂丛神经阻滞（CCB）作为一种新的臂丛神经阻滞方法引起了关注。人体解剖学研究已经确定了锁骨下间隙为锁骨中点和第一肋骨之间的区域。该空间容纳臂丛神经、腋动脉和静脉。其浅而固定的位置使其成为锁骨下臂丛神经阻滞的有前途的选择，提供安全可靠的镇痛效果。CCB 结合了实时超声可视化神经阻滞针、避免外周血管和局部麻醉剂靶向输送到神经的优势。因此，它显著降低了其他经典方法（如肌间沟臂丛神经阻滞（ISB）、锁骨上臂丛神经阻滞（SCB）、锁骨外侧矢状位臂丛神经阻滞（LS-ICB）和腋路臂丛神经阻滞）相关的并发症。这些并发症包括膈神经麻痹、臂丛神经阻滞不完全和气胸。本综述探讨了锁骨下臂丛神经阻滞的文献，讨论了解剖位置、操作、临床适应证、局部麻醉剂浓度和体积的选择以及 CCB 的连续神经阻滞。目的是为未来的临床实践和提高安全性提供基础。
