For every practical purpose - not obligatory connected with catheterization - my advise to perform that swipe from interscalene to supraclavicular regions slowly, not losing a plexus out of view. In case of poor visualization in classical place, l could usually easily find a couple of centimeters of nice, compact brachial plexus between the interscalene groove and before the subclavian artery appears into view, making an easy and ergonomical anterior approach impossible
A common issue in general. Placement depends on what you want to achieve though. Supraclav. is fine for more distal procedures (we use it for hand/upper extremity replant-surgery only i.e.) but for i.e. shoulter-TEP you want to get proximal branches of C4 and C5 (N dorsalis scapulae, N thoracius longus, N suprascapularis, Nn supraclav.) to achieve better results in painrelief and muscle relaxation proximal to surgery site. It is sufficient to perform a supraclav catheter placement though, you just don't get these patients completely pain free (in my experience)
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Great presentation , Is placement of catheter with out of plane technique more interesting?
Great presentation, thank you. I want more explanation about catheter placement through needle.
For every practical purpose - not obligatory connected with catheterization - my advise to perform that swipe from interscalene to supraclavicular regions slowly, not losing a plexus out of view. In case of poor visualization in classical place, l could usually easily find a couple of centimeters of nice, compact brachial plexus between the interscalene groove and before the subclavian artery appears into view, making an easy and ergonomical anterior approach impossible
very well explained!! Thx a lot Prof Hadzic 👌👍
You are welcome!
Thanxxx for your excellent work
Thanks and welcome
why not have a catheter in the supraclavicular area? When they peeled off the film, they almost pulled out the catheter))
A common issue in general. Placement depends on what you want to achieve though. Supraclav. is fine for more distal procedures (we use it for hand/upper extremity replant-surgery only i.e.) but for i.e. shoulter-TEP you want to get proximal branches of C4 and C5 (N dorsalis scapulae, N thoracius longus, N suprascapularis, Nn supraclav.) to achieve better results in painrelief and muscle relaxation proximal to surgery site. It is sufficient to perform a supraclav catheter placement though, you just don't get these patients completely pain free (in my experience)