Using ultrasound, Dr. Rosenblum locates the brachial plexus in the supraclavicular fossa, then views the needle as he places his needle and watches the distribution of the analgesia around the nerves to confirm a successful block.
so i'm going to do a brachial plexus block uh this patient has a c8 radiculopathy and she did very well with the first injection under fluoroscopy it was a selective nerve block using a fluoroscope and ultrasound to find the nerve today i'm going to look to repeat that to some level but i may actually go to the supraclavicular brachial plexus and and anesthetize that region so now i'm going to scan looking for the subclavian artery and the brachial plexus nerves in the supraclavicular fossa and i'm going to scan backwards i'll find the interscalene brachial plexus lining up right here and her radiculopathy is actually lower down at c8 so you're not going to see the c8 nerve is clearly that's why i'm going to go more distal back to the supraclavicular brachial plexus i'll tell you when i do root pinch tell me to come to the side and spray so i'll tell you where him in a second see the nerves around the subclavian artery i'm going to give her a little injection over here first so tyron if you need a skin though right there okay a little pinch right okay okay all right good your skin is numb you hopefully won't feel too much now okay good excellent nail's already inside looking close to the nerves in your hand you may feel something shoot down the hand feel that you're going is it what your pain is um okay just don't move too much press saves bottom right corner right here there's one different aspect of the nerves sorry okay so good hurts okay so we're just giving a few milliliters of blue pivoting mixed with dexamethasone around the brachial plexus in the clavicular fossa sorry where is that i feel like going down is it where your pain is um no it's going down like that different spot okay let's go move the needle away from that the first one was the best okay so go where we know is good okay all sides of the plexus you
