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Brachial Plexus Block
Views: 8022 - Comments: 5
Kristin Spring, CVT, VTS (ECC, Anes.), CVPP, discusses a brachial plexus block; how to set up and perform the block, and which nerves will be pain-free after the block is performed.
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Kristin Spring
CVT CVPP, VTS(Anes.), VTS(ECC)
Enrolled: 08/2011
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Thank you for this video! I'm studying for my gross anatomy midterm and it was super helpful.
Can you show us the math to come up with the 15mL total volume for this patient? What dose of bupivicaine do you use, etc.?
Hi Katie, for local blocks the dose of bupivicaine is 1.5-3mg/kg. Even in a dog this size, the volume of bupivicaine is relatively small so we will dilute with saline to allow us to cover the area needed. The brachial plexus block does require a relatively large volume in order to work properly and we aim for 10-15ml of total volume depending on the size of the dog.
Are sterile gloves not indicated here?
How can you tell for sure you are in the right spot? Is there a way to check like there is with an epidural?
Hi Kimberly: Great questions! This is a single injection that doesn't enter a body cavity so sterile gloves are not entirely necessary. With this blinded and palpation technique there is not an indicator of whether you are in the correct location like the "hanging drop" technique of an epidural. Studies of this blind technique do show good and higher success of the block with increasing injection volumes...these are cadaver studies in which they inject a dye and dissect out the number of nerves from the plexus that are stained. Studies using a nerve locator or nerve stimulator device have demonstrated better block success than blinded techniques and allows the use of smaller injection volumes though using a nerve locator typically takes more time to perform.