Effect of body mass index on angle of needle insertion during ultrasound-guided lateral sagittal infraclavicular brachial plexus block.
OBJECTIVE
The aim of our study was to establish the angle of needle insertion from the anterior chest wall during ultrasound-guided infraclavicular brachial plexus block and to examine for any correlation between body mass index (BMI) and insertion angle.


METHODS
This is a prospective observational study.


METHODS
The setting is at an operating room, university-affiliated teaching hospital.


METHODS
The patients are 23 American Society of Anesthesiologists physical status 1-3 patients scheduled to undergo elbow, forearm, or hand surgery under regional anesthesia with or without general anesthesia.


METHODS
The intervention is infraclavicular brachial plexus block with or without perineural catheter insertion.


METHODS
The measurement is the angle of needle insertion in relation to the anterior chest wall, BMI, and needle visibility as graded by the anesthesiologist.


RESULTS
Twenty-three patients were studied. The mean (SD) BMI was 28.5 (5.4). The median (range) of angle of needle insertion was 50 (33-60). The Pearson correlation coefficient for BMI and angle of needle insertion was 0.357. There were no reported complications.


CONCLUSIONS
The median (range) angle of needle insertion in relation to chest for our study patients was 50° (33°-60°). The needle visibility was rated difficult, requiring hydrolocation or "heeling-in," in 39% of cases. There was a moderate correlation between BMI and angle of insertion. Despite difficulties with needle visualization, the ultrasound-guided infraclavicular brachial plexus block provided reliable analgesia.
Department of Anesthesia, Cleveland. Clinic, Anesthesiology Institute, OH, USA.
Hari K P
HK
Kalagara
Department of Anesthesia, Dalhousie University, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada. Electronic address: vishal.uppal3@gmail.com.
Vishal
V
Uppal
Department of Anesthesia, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom.
Sonya
S
McKinlay
Department of Anesthesia, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom.
Alan J R
AJ
Macfarlane
Department of Anesthesia, Foothills Medical Centre, Calgary, Alberta, Canada.
Keith
K
Anderson
D000768:Anesthesia, General / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D015992:Body Mass Index; D065527:Brachial Plexus Block / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009339:Needles; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*
D000779:Anesthetics, Local
Angle of needle insertion; Body mass index; Infraclavicular brachial plexus block