Parasagittal Vs Corner-pocket Approaches for Ultrasound-guided Supraclavicular Brachial Plexus Block: Review Article | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 73, Volume 100, Issue 1, July 2025, Page 3042-3052 PDF (688.3 K) | ||||
| DOI: 10.21608/ejhm.2025.442174 | ||||
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| Abstract | ||||
| Background: Supraclavicular brachial plexus block (SCBPB) under Ultrasound (US) guidance is widely used to provide rapid, dense anaesthesia for upper limb surgeries. However, approaches such as the corner pocket technique may have limitations in needle visualization and risk pneumothorax, while the parasagittal method offers alternative rib protection. US imaging is a portable, non-invasive modality that allows point-of-care evaluation of nerve anatomy in the operating theatre, intensive care unit, and emergency department, facilitating safer peripheral nerve blockade. Despite growing adoption, comparative evidence on block performance, complication rates, and procedural efficiency remains limited. Objective: This review compared parasagittal and corner pocket approaches for US-guided SCBPB, evaluating block onset, needle visualization, efficacy, and complications. Methods: A thorough search was carried out in PubMed, Google Scholar, and Science Direct for Supraclavicular Brachial Plexus Block through the period from 2006 to 2023. Only the most recent or comprehensive study was considered. Oral presentations, dissertations, conference abstracts, and unpublished papers are a few examples of works that weren't considered important scientific study. Documents published in languages other than English were ignored as a result of lack of translation resources. Conclusions: Both parasagittal and corner pocket techniques achieve high success rates and reliable onset times for SCBPB under US guidance. The parasagittal approach offers enhanced needle visualization, deeper rib protection reducing pneumothorax risk, and improved consistency in local anaesthetic spread. The corner pocket method remains effective with shorter learning curves but may incur higher risk of pleural proximity. Ultimately, selecting the appropriate technique should consider operator experience, case anatomy, and procedural setting. Future studies should standardize protocols, assess learning curves, and evaluate case-centred outcomes to guide best practices. | ||||
| Keywords | ||||
| Supraclavicular brachial plexus block; US guidance; Parasagittal approach; Corner pocket approach; Peripheral nerve block | ||||
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