In this video we discuss the costoclavicular block, outlining the rationale, anatomy, sonoanatomy as well as some tips and tricks to perform the block safely and effectively
Great video as usual, JG! Supraclavicular was my favourite upper limb block but I have a feeling this is gonna usurp the SC! I not infrequently find it difficult to get enough real estate in the supraclavicular fossa, either due to short neck or body habitus (not otherwise specified). Sometimes due to equipment limitation (large linear probe footprint). I am so excited to try this. Cheers!
Very nice video! To become familiar with the sono-anatomy, before I started to perform this block, I used that trick at the end of the video, i.e. looking for LA spread in other positions than costo-clavicular, the other way around: I would do a "classic" infraclavicular block with the probe perpendicular to the clavicle and needle aimed @ the 6 o'clock position under the artery, then afterwards scan the costo-clavicular area. You will typically find the three cords (lateral on top, posterior and medial on the bottom, thus forming a triangle rather than a bunch of grapes in my hunmle opinion) surrounded by LA. The separation from the surrounding tissues by the LA gets that "pattern recognition" going, making it easier to recognize the cords when you are ready to give this block a go.
the big unanswered question - if costoclavicular is similar to supraclavicular, what are the indications and/or benefits of doing one over the other? excellent video otherwise.
You do it when you want a shoulder surgery type block but with a low (3-5%) risk of phrenic nerve palsy. Typically that would be in a respiratory cripple.
@@JUSSTTIINFU3K versus the ~50% incidence with the supraclavicular approach. surprising they omitted this key point from the video.. thanks for the reply
Interesting approach. Great informative, concise video. Thank you.
Love the post block scanning.
Great video as usual, JG! Supraclavicular was my favourite upper limb block but I have a feeling this is gonna usurp the SC! I not infrequently find it difficult to get enough real estate in the supraclavicular fossa, either due to short neck or body habitus (not otherwise specified). Sometimes due to equipment limitation (large linear probe footprint). I am so excited to try this. Cheers!
Very nice video!
To become familiar with the sono-anatomy, before I started to perform this block, I used that trick at the end of the video, i.e. looking for LA spread in other positions than costo-clavicular, the other way around: I would do a "classic" infraclavicular block with the probe perpendicular to the clavicle and needle aimed @ the 6 o'clock position under the artery, then afterwards scan the costo-clavicular area. You will typically find the three cords (lateral on top, posterior and medial on the bottom, thus forming a triangle rather than a bunch of grapes in my hunmle opinion) surrounded by LA. The separation from the surrounding tissues by the LA gets that "pattern recognition" going, making it easier to recognize the cords when you are ready to give this block a go.
So happy this vdo is launched, i have been waiting for this approach and yours is the best!
Beautifully explained ❤
how i love your content! Thank you very much.
Thanks
Excellent.
Thanks so much
What Sonography device are you using?
You use 0.75% ropi 20 mls?
Excellent video presentation Sir
Sir is there sparing of posterior cutaneous nerve of arm like we see in supraclavicular block??
👌
The medial approach seems to risky on paper to scrape by the axillary artery.
How can I avoid cephalic vein puncture
Just watch the whole video -> 5:06
the big unanswered question - if costoclavicular is similar to supraclavicular, what are the indications and/or benefits of doing one over the other?
excellent video otherwise.
You do it when you want a shoulder surgery type block but with a low (3-5%) risk of phrenic nerve palsy. Typically that would be in a respiratory cripple.
@@JUSSTTIINFU3K versus the ~50% incidence with the supraclavicular approach. surprising they omitted this key point from the video.. thanks for the reply