Ultrasound Guided Cervical Plexus Block Cadaver Training

Abstract

Background Ultrasound guided techniques have become increasingly used in medicine to increase success rates and decrease complications of procedures such as central line placements, paracentesis, and regional nerve blocks. Ultrasound guided brachial plexus blocks are commonly used in surgeries and procedures involving the distal clavicle, shoulder, and proximal humerus. A majority of the training for nerve blocks were previously done on the job with live patients. There is limited research behind training on human cadavers. Ultrasound guided nerve block training on cadavers would enhance training for any medical education that involves such skill sets. Methods Fresh human cadavers were imaged using a Butterfly ultrasound on the nerve imaging preset. The brachial plexus was imaged in the transverse plane superior to the clavicle. The supraclavicular artery was used as the initial landmark. The probe was then moved superiorly until the anterior and middle scalenes came into view. A 25 gauge 1 inch needle was inserted in the transverse plane between the anterior and middle scalenes. Saline was then used to simulate local anesthetics and injected between the anterior and middle scalenes to simulate a brachial plexus nerve block. Results The images obtained from fresh human cadavers provided a more realistic image of the brachial plexus and surrounding structures such as the anterior and middle scalenes, the sternocleidomastoid, and the surrounding fascia compared to a phantom model of a nerve plexus. A fresh human cadaver was adequately able to simulate a nerve block in a live patient. Conclusion Cadaver ultrasound guided nerve block training would be an effective model to provide both medical students and interns to enhance their skills outside of the clinical setting. The realistic experience through cadavers would decrease the patient's procedural discomfort and increase confidence and the success rate of providing regional anesthesia including a brachial plexus block.