Very nice video! To become familiar with the sono-anatomy, before I started to perform this block, I used that trick at the end of the video, i.e. looking for LA spread in other positions than costo-clavicular, the other way around: I would do a "classic" infraclavicular block with the probe perpendicular to the clavicle and needle aimed @ the 6 o'clock position under the artery, then afterwards scan the costo-clavicular area. You will typically find the three cords (lateral on top, posterior and medial on the bottom, thus forming a triangle rather than a bunch of grapes in my hunmle opinion) surrounded by LA. The separation from the surrounding tissues by the LA gets that "pattern recognition" going, making it easier to recognize the cords when you are ready to give this block a go.
Great video as usual, JG! Supraclavicular was my favourite upper limb block but I have a feeling this is gonna usurp the SC! I not infrequently find it difficult to get enough real estate in the supraclavicular fossa, either due to short neck or body habitus (not otherwise specified). Sometimes due to equipment limitation (large linear probe footprint). I am so excited to try this. Cheers!
the big unanswered question - if costoclavicular is similar to supraclavicular, what are the indications and/or benefits of doing one over the other? excellent video otherwise.
You do it when you want a shoulder surgery type block but with a low (3-5%) risk of phrenic nerve palsy. Typically that would be in a respiratory cripple.
@@JUSSTTIINFU3K versus the ~50% incidence with the supraclavicular approach. surprising they omitted this key point from the video.. thanks for the reply
Interesting approach. Great informative, concise video. Thank you.
Very nice video!
To become familiar with the sono-anatomy, before I started to perform this block, I used that trick at the end of the video, i.e. looking for LA spread in other positions than costo-clavicular, the other way around: I would do a "classic" infraclavicular block with the probe perpendicular to the clavicle and needle aimed @ the 6 o'clock position under the artery, then afterwards scan the costo-clavicular area. You will typically find the three cords (lateral on top, posterior and medial on the bottom, thus forming a triangle rather than a bunch of grapes in my hunmle opinion) surrounded by LA. The separation from the surrounding tissues by the LA gets that "pattern recognition" going, making it easier to recognize the cords when you are ready to give this block a go.
Love the post block scanning.
Great video as usual, JG! Supraclavicular was my favourite upper limb block but I have a feeling this is gonna usurp the SC! I not infrequently find it difficult to get enough real estate in the supraclavicular fossa, either due to short neck or body habitus (not otherwise specified). Sometimes due to equipment limitation (large linear probe footprint). I am so excited to try this. Cheers!
So happy this vdo is launched, i have been waiting for this approach and yours is the best!
Beautifully explained ❤
how i love your content! Thank you very much.
Excellent.
What Sonography device are you using?
You use 0.75% ropi 20 mls?
Thanks so much
Thanks
Excellent video presentation Sir
Sir is there sparing of posterior cutaneous nerve of arm like we see in supraclavicular block??
How can I avoid cephalic vein puncture
Just watch the whole video -> 5:06
The medial approach seems to risky on paper to scrape by the axillary artery.
👌
the big unanswered question - if costoclavicular is similar to supraclavicular, what are the indications and/or benefits of doing one over the other?
excellent video otherwise.
You do it when you want a shoulder surgery type block but with a low (3-5%) risk of phrenic nerve palsy. Typically that would be in a respiratory cripple.
@@JUSSTTIINFU3K versus the ~50% incidence with the supraclavicular approach. surprising they omitted this key point from the video.. thanks for the reply