Ultrasound guided Supraclavicular nerve block

Ultrasound guided Supraclavicular nerve block to augment low volume interscalene block for shoulder surgery, for breast surgery, pain relief after clavicle fracture and central line insertions

[@fang9872]

doctor narayanan. thanks for the video. one small mistake in this video : at C4 plane, the muscle is Levator scapulae muscle but not the middle scalene muscle. so should we block the nerve at C5 plane at top of middle scalene muscle ?

[@mnar76]

Thanks for the feedback. Yes you are correct, it is indeed Levator scapulae at C4. Slightly lower down, the posterior and middle scalene come into view. The higher the level of block and lower the volume, the less likely phrenic or spinal accessory nerves are blocked. The relationship to vertebral level is only a rough rule and may not always be consistent. Where ever the supraclavicular nerves are seen emerging behind the posterior border of sternomastoid and penetrating the superficial fascia, they need to be targeted there.