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Supraclavicular Block Completeness — FRCA Final MCQ

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ModerateRegional AnaesthesiaSupraclavicular Block CompletenessFRCA Final

A 45-year-old man (ASA II) requires ulnar nerve transposition surgery. An ultrasound-guided supraclavicular brachial plexus block is planned. What single advantage does the supraclavicular approach have over other brachial plexus approaches for surgery at the elbow?

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Correct answer: C — Provides the most complete block of all brachial plexus terminal nerves in the upper limb from a single injection

The supraclavicular approach targets the brachial plexus at the level of the trunks/divisions, where all three trunks are packed tightly together in a compact area lateral to the subclavian artery above the first rib. This provides the most consistent, complete block of all terminal nerves from a single injection ('the spinal of the arm'). The axillary approach may miss the musculocutaneous nerve (already separated). The interscalene approach commonly spares C8-T1 (ulnar nerve territory). The supraclavicular approach does carry a risk of pneumothorax and phrenic nerve palsy (~50%).

Reference: RCOA – 2023 – Regional anaesthesia module; Tran DQ – 2020 – Supraclavicular block