Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space: A Cadaver Anatomic Study
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摘要Background and Objectives: The costoclavicular space (CCS), which is located deep and posterior to the midpoint of the clavicle, may be a better site for infraclavicular brachial plexus block than the traditional lateral paracoracoid site. However, currently, there is paucity of data on the anatomy of the brachial plexus at the CCS. We undertook this cadaver anatomic study to define the anatomy of the cords of the brachial plexus at the CCS and thereby establish the anatomic basis for ultrasound-guided infraclavicular brachial plexus block at this proximal site.

Methods: The anatomy and topography of the cords of the brachial plexus at the CCS was evaluated in 8 unembalmed (cryopreserved), thawed, fresh adult human cadavers using anatomic dissection, and transverse anatomic and histological sections, of the CCS.

Results: The cords of the brachial plexus were located lateral and parallel to the axillary artery at the CCS. The topography of the cords, relative to the axillary artery and to one another, in the transverse (axial) plane was also consistent at the CCS. The lateral cord was the most superficial of the 3 cords and it was always anterior to both the medial and posterior cords. The medial cord was directly posterior to the lateral cord but medial to the posterior cord. The posterior cord was the lateral most of the 3 cords at the CCS and it was immediately lateral to the medial cord but posterolateral to the lateral cord.

Conclusions: The cords of the brachial plexus are clustered together lateral to the axillary artery, and share a consistent relation relative to one another and to the axillary artery, at the CCS.
著者Sala-Blanch X, Reina MA, Pangthipampai P, Karmakar MK
期刊名稱Regional Anesthesia and Pain Medicine
出版年份2016
月份5
卷號41
期次3
出版社LIPPINCOTT WILLIAMS & WILKINS
頁次387 - 391
國際標準期刊號1098-7339
電子國際標準期刊號1532-8651
語言英式英語
Web of Science 學科類別Anesthesiology

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