Comparison of different arm positions and angles with ultrasound for infraclavicular block

Abstract

Aim: Nerve blocks are used more frequently with the introduction of ultrasound. Anesthesiologists prefer the infraclavicular nerve block because of its ease of administration and lack of complications. During the infraclavicular block, it is unclear to what angle the arm is to be given and in what position it is to be made. In our study, we aimed to measure and compare the distances of the axillary artery from the skin by giving different angles to the arm in the presence of ultrasound. Material and Methods: A total of 30 volunteers between the ages of 20-65 included in the study. While the forearm was in the anatomic position (Group A), the arm abducted from the shoulder at 0.45 and 90 degrees. At each angle, the distances of the different points of the axillary artery (posterior, anterior and central) to the skin compared. The same measurements repeated by flexing the forearm at 90 degrees from the elbow (Group B). Results: In Group A and Group B, the distances of all points of the axillary artery to the skin found to be inversely proportional to the abduction angle. In all measurements, the shortest skin distance found at 90 degrees of abduction angle (p< 0.05). There was no statistically significant difference between Group A and Group B in the same angles Conclusion: When performing ultrasound guided infraclavicular block, anesthesiologists should prefer the easiest method. We found that the distance of the axillary artery to the skin and needle entry decreased as the abduction angle of the arm increased in three different measurements. As a result of our study, we believe that the best angle for the infraclavicular block can be done by giving 90 degree abduction angle to the arm.