Retroclavicular approach to the infraclavicular region, the probe will be placed below and perpendicular to the clavicle, in a paramedian sagittal plane, medial to the coracoid process, to obtain a short-axis view of the cords of the brachial plexus and the axillary vessels. The needle will then be inserted in the supraclavicular fossa, approximately 1 cm posteriorly to the clavicle, and advanced in plane and strictly parallel to the ultrasound transducer. After passing the initial blind zone of about 2 cm caused by the acoustic shadow of the clavicle, the needle tip will be constantly seen, until it will be positioned posterior to the axillary artery.

A new approach to the infraclavicular block The ultrasound transducer will be placed parallel and inferior to the clavicle and angled cephalad to optimize the ultrasound view. The block needle will be inserted in-plane from a lateral to medial direction into the costoclavicular space and the entire drug will be deposited in this location

Infraclavicular brachial plexus block (ICPB) ultrasound probe will be placed near the lower edge of the clavicle, and a transverse view of the subclavian artery and vein will be visualized. Using a needle guide, the needle will be advanced under real-time ultrasound guidance, and local anaesthetic will be injected near the subclavian artery, 15 mm medially and 15 mm laterally to the artery. The extent of sensory and motor block will be evaluated at 30 minutes after the injection

Using ultrasound in 3different techniques of infraclavicular brachial plexus block

Success rate 30 min after local anasthetic injections