@article{Herrera_Mojica_Nieuwveld_Prats-Galino_López_Sala-Blanch_2017, title={Ultrasound guided supraclavicular perivascular block. Anatomical, technical medial approach description and changes in regional perfusion}, volume={45}, url={https://www.revcolanest.com.co/index.php/rca/article/view/552}, abstractNote={<div class="section"> <p class="sub-subsec">Introduction:</p> <p>Supraclavicular block is usually performed using a lateral to medial approach, although a medial to lateral approach is also feasible. Block onset may be evaluated through the sympathetic effect associated with the sensitive and motor blockade.</p> </div> <div class="section"> <p class="sub-subsec">Objective:</p> <p>To describe the ultrasound-guided supraclavicular block using a medial approach, evaluating the sensitive, motor, and sympathetic block onset.</p> </div> <div class="section"> <p class="sub-subsec">Materials and methods:</p> <p>An ultrasound-guided supraclavicular block was performed in a fresh cadaver with 20 ml volume (2 ml of iodine and 1 ml of methylene blue). A CT scan was performed and sagittal sections were obtained. The clinical phase included 10 patients undergoing a medial approach block; the onset of the block was evaluated based on a motor, sensory and sympathetic assessment (measuring flow changes in the humeral artery, the palmar temperature, and the perfusion index).</p> </div> <div class="section"> <p class="sub-subsec">Results:</p> <p>Adequate distribution of the contrast medium was observed in the cadaver, with complete spread through the brachial plexus, both in terms of the CT-reconstruction as in the anatomical cross sections. A significant change in all the sympathetic block parameters was observed 5 min after the bock: temperature (32.5 ± 1.8 °C to <strong>33.4</strong> ± 1.7 °C; <em>p =</em> 0.047), humeral arterial flow (105 ± 70ml/min to192 ± 97ml/min; <em>p =</em> 0.007), and thumb perfusion index (5 ± 3 to 10 ± 3%; p=0.002). The block was effective and uneventful in all patients.</p> </div> <div class="section"> <p class="sub-subsec">Conclusions:</p> <p>This supraclavicular approach achieves a homogeneous distribution throughout the brachial plexus, with high anesthetic efficacy. Regional changes secondary to the sympathetic block occur early after the block.</p> </div>}, number={4}, journal={Colombian Journal of Anesthesiology}, author={Herrera, Ana Eugenia and Mojica, Viviana and Nieuwveld, Daniela and Prats-Galino, Alberto and López, Ana María and Sala-Blanch, Xavier}, year={2017}, month={Oct.}, pages={272–279} }