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Suprascapular Nerve Block (Anterior Approach above the Clavicle)

The suprascapular nerve (SSN) arises from the superior trunk of the brachial plexus, containing contributions from the C5 and C6 ventral rami. The SSN provides the majority of the sensory innervation of the shoulder joint (approximately 70% on anatomic dissections). There also are articular fibers carried by the axillary nerve, lateral pectoral nerve, and the nerve to the subscapularis. Isolated SSN block may be indicated in…

Interscalene and Supraclavicular Blocks (of the Brachial Plexus)

The first reported use of ultrasound to guide regional block was for brachial plexus block above the clavicle. These pioneers used an offline Doppler technique to mark the position of the subclavian artery as a surrogate landmark of the brachial plexus. Although today there may be many criticisms of this technique, their results were impressive: a 98% success rate with no complications. Ultrasound imaging blurs the…