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A New Parascalene Approach to the Brachial Plexus in Children: Comparison with the Supraclavicular Approach

A technique for blocking the brachial plexus was designed after reevaluation of the gross anatomy of the neck in children. It consists of penetrating the perineural sheath at the level of the omohyoid muscle using a strictly anterior-posterior direction for insertion of the needle. This procedure was prospectively evaluated in 60 children (group P) and compared with classical supraclavicular approach in 60 similar patients (group S). Insulated needles and a nerve stimulator were used with both techniques. Although both techniques produced a high degree of sensory blockade in almost all infraclavicular branches of the brachial plexus, the parascalene approach proved to be easier and more reliable while also being almost free of complications.