**12. Complications**


Anesthesia for Arthroscopic Shoulder Surgery 61

an even distribution of the local anesthetic will produce blockade in all the territories dependent on the brachial plexus nerve in > 80% of cases. To achieve uniform distribution of the anesthetic, a slow injection is paramount, along with high resolution ultrasound to

Fig. 6. A. Ultrasound anatomy of the supraclavicular brachial plexus. B. Schematic

representation of the scalene muscles (orange), subclavian artery (red), first rib (white) and

The Brachial plexus blockage via the supraclavicular approach has some notable

 In the supraclavicular block, a single, uniformly distributes injection of local anesthetic may achieve a total blockage of all forearm and arm nerve territories, including the medial cutaneous nerves of the arm, the musculocutaneous forearm nerves and the

Compared with infraclavicular blockage, supraclavicular access is more effective in

Pneumothorax: classically described as late onset, although direct visualization of the

Systemic toxicity: direct intravascular injection (test by prior aspiration) or by

terms of radial blockade of the territory using a single puncture technique.

Changes in phonation: hoarseness if the recurrent nerve is involvement (rare).

pleura during blockade should reduce this potential complication.

Horner's syndrome: due to blocking the stellate ganglion.

directly observe its distribution.

brachial plexus (Yellow)

axillary nerve.

**15. Complications** 

absorption of the anesthetic. subclavian Subclaviar arterial puncture. ipsilateral Ipsilateral phrenic nerve palsy.

advantages:

Other considerations and peculiarities:

