Brachial Plexus Blocks

Interscalene (best for shoulder surgery)

• Blocks Roots/Trunks of Brachial Plexus
• 100% phrenic nerve paralysis
• Horner’s syndrome
• Hoarseness- recurrent laryngeal nerve

Supraclavicular (best for elbow, distal arm surgery)

• Blocks Divisions of Brachial Plexus
• 50% risk of phrenic nerve paralysis
• Pneumothorax (0.5-6% risk)
• Horner’s syndrome

Infraclavicular (best for arm, hand surgery)

• Blocks Cords of Brachial Plexus
• Highest risk for pneumothorax

Axillary (forearm and hand surgery)

• Blocks Terminal Branches of Brachial Plexus
• Can purposefully omit blocking the musculocutaneous nerve to preserve elbow flexion
• Need to add an intercostal brachial skin wheel to cover tourniquet pain