Comparison of ultrasound guided costoclavicular brachial plexus block versus supraclavicular brachial plexus block for forearm and hand surgeries.

The costoclavicular brachial plexus block was recently described as an alternative approach to infraclavicular block.It targets the brachial plexus in the proximal infraclavicular fossa where the lateral ,medial,and posterior cords are tightly bundled together.The compact organization of the plexus at this level,clustered lateral to the artery provides a reliable sensory Motar block when local anaesthetics is deposited between the three cords of the brachial plexus.Costoclavicular space includes a triangular area wedged between the pectoralis major and the subclavius muscle anteriorly and anterior rib cage posteriorly,the goal of costoclavicular approach is to place the needle tip near the clustered cords which is relatively easier than in infraclavicular approach where it is variable and in deeper locations.