• Michael J Fredrickson, Philip Wolstencroft, Ritwik Kejriwal, Albert Yoon, Michael R Boland, and Simon Chinchanwala.
• Department of Anaesthesiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. michaelfredrickson@yahoo.com
• Anesth. Analg. 2010 Nov 1;111(5):1325-7.

BackgroundThe optimal site for local anesthetic placement during ultrasound-guided infraclavicular block remains controversial.MethodsPatients were randomized to receive lidocaine 2% 30 mL as a single injection posterior to the axillary artery (n = 51) or a triple injection ideally adjacent to each brachial plexus cord (n = 49). Pinprick sensory and motor block (3 = no block, 0 = complete block) were assessed to 20 minutes in the 4 distal nerve territories.ResultsThe single injection group was not significantly inferior (single versus triple injection median [interquartile range] 20-minute aggregate block score: 5 [2-9] vs 7 [3.5-11]) but also demonstrated superiority (2-tailed test, P = 0.043). The single injection technique was associated with a small reduction in procedural time.ConclusionsThe optimal site for local anesthetic placement during ultrasound-guided infraclavicular block is a single point injection posterior to the axillary artery.

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