Forelimb Brachial Plexus Block

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B. Braun Vet Care
Products & Therapies
Anesthesia
Regional Anesthesia
Peripheral Nerve Block
Brachial Plexus Block

Indication

Operations of the forelimb below the border of the middle to distal third of the humerus

Step by step

Patient positioning
Acromion, tuberculum majus humeri (black dots), imaginary extension of the jugular vein (black line)
Axillary artery (red), axillary vein (blue), brachial plexus (yellow), 1st rib (grey)
Arrow = direction of needle insertion
Patient positioning
Acromion, tuberculum majus humeri (black dots), imaginary extension of the jugular vein (black line)
Axillary artery (red), axillary vein (blue), brachial plexus (yellow), 1st rib (grey)
Arrow = direction of needle insertion

Local anesthetics

Brachial plexus block (Nerve stimulation)

Local anesthetics: Lidocain 1-2%, Mepivacain 1-2%, Bupivacain 0.5%, Ropivacain 0.75%
Initial setting NS: 0.5-1.0 mA, 2 Hz, 0.10 ms
Muscle contraction: elbow flexion and extension
Reduction of the amperage: in small increments to <0.5 mA
Correction of the needle position: minor corrections only, pull back needle, correct angle, re-advance needle
MSC control: to avoid block failure
Aspiration and injektion: slowly, Raj test, BSmart
Injection volume: 0.25-0.3 ml/kg
(Campoy et al. 2008)

Videos

  • Brachial plexus block (Nerve stimulation)

  • Brachial plexus block (Nerve stimulation/US)

    (Campoy et al. 2010)

  • Brachial plexus block (Nerve stimulation/US)

Axillary artery and vein (red/blue), nerves of the brachial plexus (white arrows), stimulation needle (blue arrows)
With the friendly assistance of
https://ktpraxis-berlin.de
Dr. Georg Papadopoulos
Veterinary Specialist for Small Animals
Additional Certification: Anesthesia in Small Animals
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B. Braun Vet Care GmbH
Am Aesculap Platz
78532 Tuttlingen
Germany

Disclaimer

As with any intervention in the body, peripheral nerve blocks also carry the risk of complications. The presented procedures and dosages are thoroughly reviewed and based on currently available scientific data and clinical experience but should only be considered as guidelines along the contents of the course. The responsibility for performing the nerve blocks shown on this site as part of any anesthesia regimen or pain management lies with the executing clinician. B. Braun Vet Care GmbH and Dr. Papadopoulos cannot be held responsible for any complications or adverse effects, that may arise from the described techniques or for any mistakes in the information provided.