NYSORA’s Ultrasound-guided supraclavicular brachial plexus block highlights the anatomy and technique description for a successful block.

Clinical Updates

Nanda and Auyong (Current Opinion in Anesthesiology, 2026) report that phrenic-sparing strategies for shoulder surgery involve a trade-off between respiratory safety and block completeness: reducing interscalene block volume/concentration or using superior trunk and supraclavicular approaches lowers but does not eliminate hemidiaphragmatic paresis (HDP). Distal combinations, particularly suprascapular nerve block with anterior axillary or infraclavicular block, can reduce HDP to near zero while maintaining useful shoulder analgesia, making them particularly relevant for patients with limited respiratory reserve; ISB remains the most reliable option when complete analgesia or surgical anesthesia is the priority.

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