title: Sonographic assessment of arterial frequency and distribution within the brachial plexus: a comparison with the cadaveric record.
abstract: We investigated the number and distribution of arteries within the brachial plexus territory using a portable ultrasound device, and compared these findings with known cadaveric data. We recruited 200 volunteers and carried out 400 brachial plexus examinations in a prospective observational study design. We identified arteries within the brachial plexus in more than 90% of subjects. Most of these were located in the upper and middle zones of the plexus and therefore lie within the possible path of a block needle. These findings correlate well with previous cadaveric studies, suggesting that arteries within the brachial plexus territory can be reliably identified with a portable ultrasound device. The presence of these vessels may impact upon the safety and efficacy of brachial plexus blockade. Routine pre-procedural sonographic assessment may offer improved safety and efficacy. You can respond to this article at http://www.anaesthesiacorrespondence.com.
authors.affiliation: Department of Anaesthesia, Norfolk and Norwich University Hospital, Norwich, UK. pnambyiah@doctors.org.uk
authors.forename: P
authors.initials: P
authors.lastname: Nambyiah
authors.forename: K
authors.initials: K
authors.lastname: Umbarje
authors.forename: R
authors.initials: R
authors.lastname: Amir
authors.forename: M
authors.initials: M
authors.lastname: Parikh
authors.forename: S A vR
authors.initials: SA
authors.lastname: Oosthuysen
mesh_terms: D000293:Adolescent; D001158:Arteries / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D001917:Brachial Plexus / Q000098:blood supply* / Q000000981:diagnostic imaging; D002102:Cadaver; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009407:Nerve Block / Q000295:instrumentation; D011446:Prospective Studies; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color