Unexpected venous anomaly around the brachial plexus during supraclavicular block: A case report

Anatomical variations in the supraclavicular region can greatly affect the success and safety of regional anesthesia techniques, particularly supraclavicular brachial plexus blocks. Identifying these variations is essential to minimize risks. This case involves a 32-year-old male patient with a distal humeral fracture, where an ultrasound-guided supraclavicular block revealed an unusual venous structure encircling the brachial plexus. This atypical vein could pose significant risks, including vascular injury, local anesthetic toxicity, and even cardiac arrest, depending on the anesthetic uBased on its anatomical location and Doppler features, the vein was hypothesized to originate from the subclavian or external jugular vein. This finding underscores the critical importance of thorough ultrasound evaluation and real-time guidance during the procedure to avoid complications. Recognizing such anatomical anomalies is vital to ensuring patient safety, and the integration of ultrasound into routine regional anesthesia practice enhances both precision and effectiveness.