• Grazielle Rodrigues Silva, Danielle Gonçalves Borges, Iuri Ferreira Lopes, Roberto Araújo Ruzi, Paulo Ricardo Rabello de Macedo Costa, and Mandim Beatriz Lemos da Silva ... more BLDS Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Bra. less
• Universidade Federal de Uberlândia (UFU), Hospital de Clínicas da Faculdade de Medicina, Serviço de Anestesiologia, Uberlândia, MG, Brasil. Electronic address: grazielle.rs@gmail.com.
• Rev Bras Anestesiol. 2019 Sep 1; 69 (5): 510-513.

Background And ObjectivesCostoclavicular brachial plexus block is an anesthesia performed through the infraclavicular route described in the literature as a safe and effective route for upper limb anesthesia distal to the elbow. The following report describes the case of a patient whose traditional plexus blocking techniques presented ultrasound visualization difficulty, but the costoclavicular approach was easy to visualize for anesthetic blockade.Case ReportA grade 3 obese patient scheduled for repair of left elbow fracture and dislocation. Ultrasound examination revealed a distorted anatomy of the supraclavicular region and the axillary region with skin lesions, which made it impossible to perform the blockade in these regions. It was decided to perform an infraclavicular plexus block at the costoclavicular space, where the brachial plexus structures are more superficial and closer together, supported by a muscular structure, lateral to all adjacent vascular structures and with full view of the pleura. The anesthetic block was effective to perform the procedure with a single injection and uneventfully.ConclusionCostoclavicular brachial plexus block is a good alternative for upper limb anesthesia distal to the elbow, being a safe and effective option for patients who are obese or have other limitations to the use of other upper limb blocking techniques.Copyright © 2019 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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