Access
Depending on the occasion, a specific location of the brachial plexus is chosen for the injection of the anaesthetic, since the nerve plexus contains numerous, quite complex switchings of the individual nerves and thus the different qualities are found at different locations. A distinction is made between different approaches to brachial plexus anesthesia. In the interscale approach, the brachial plexus is blocked relatively at the beginning after passing through the scalenus gap, so that the region of the shoulder and upper arm is mainly anaesthetized.
This approach is suitable for the dislocated shoulder. The supraclavicular block is intended to numb the entire arm and is placed above the clavicle near the subclavian artery and the first rib. This method is used less frequently because the risk of a pneumothorax is too high.
A good alternative to anesthesia of the whole arm is the vertical infraclavicular block, which has a high success rate. However, it does not cover the shoulder region. The injection site is located below the collarbone and is intended to hit the compartment in which the brachial plexus is accompanied by the artery and axillary vein.This loge is also to be taken in the so-called axillary block of anesthesia, but the access is through the armpit.
Complications
In general, brachial plexus anesthesia is a safe and low complication procedure. Undesirable symptoms would be post-anaesthesia sensory disturbances caused by damage to the nerve with the hypodermic needle, as well as the formation of a bruise by puncturing one of the surrounding blood vessels. A more serious complication is the puncture of the pleura, which would cause a pneumothorax. An allergic reaction to the medication or materials used may also occur.
