Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Case Report

Ultrasound-guided continuous costoclavicular block through retrograde stimulating catheter technique for postoperative analgesia in shoulder surgery: a case seriesα

Sandeep Diwan, Divya Sethi, Parag Sancheti, Abhijit Nair

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In 5 patient undergoing surgery for proximal humerus fracture we investigated into postoperative analgesia provided by continuous costoclavicular block using continuous stimulating catheter. The postoperative pain scores were less than 4 in all patients except in two patients who required intravenous tramadol 50 mg as a rescue analgesic. The radiocontrast dye study executed in two patients revealed contiguous contrast spread through the brachial plexus sheath with the catheter tip in the interscalene space. We propose that a continuous costoclavicular block with a retrograde stimulating catheter is a feasible alternative regional anesthesia technique for postoperative analgesia in shoulder surgery.


Ultrasonography;  Regional anesthesia;  Shoulder;  Costoclavicular


[1] J.W. Li, B. Songthamwat, W. Samy, et al. Ultrasound-guided costoclavicular brachial plexus block: sonoanatomy, technique, and block dynamics Reg Anesth Pain Med., 42 (2017), pp. 233-240

[2] X. Sala-Blanch, M.A. Reina, P. Pangthipampai, et al. Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space: A Cadaver Anatomic Study Reg Anesth Pain Med., 41 (2016), pp. 387-391

[3] D.Q. Tran, S. Layera, D. Bravo, et al. Diaphragm-sparing nerve blocks for shoulder surgery, revisited Reg Anesth Pain Med. (2019), 10.1136/rapm-2019-100908 [ahead of print]

[4] C. García-Vitoria, J. Vizuete, A.M. López Navarro, et al. Costoclavicular Space: A Reliable Gate for Continuous Regional Anesthesia Catheter Insertion Anesthesiology., 127 (2017), p. 712

[5] R. Aldwinckle Costoclavicular Approach to the Supraclavicular Fossa: Journey behind the Dark Side of the Moon (Clavicle) Anesthesiology., 128 (2018), p. 1259

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