Variações anatômicas do plexo braquial e sua relevância na prática clínica do bloqueio interescalênico guiado por ultrassom: uma série de casos

Abstract

Interscalene brachial plexus block is widely used for anesthesia and analgesia in shoulder surgeries, providing effective pain control and reducing the need for opioids. Ultrasound-guided techniques enable real-time visualization of anatomical structures, increasing both safety and success rates. However, anatomical variations of the brachial plexus roots, especially C5 and C6, may alter the expected pathway and hinder the placement of catheters for continuous analgesia. This study reports a series of three cases in which such anatomical variations were identified intraoperatively, preventing the use of continuous techniques and requiring adaptations in the anesthetic plan. The analysis highlights the relevance of thorough anatomical knowledge, systematic use of ultrasound, and technical flexibility in regional anesthesia practice. Early recognition of these variations allows prevention of failures, reduction of complications, and implementation of safe alternative strategies for postoperative pain management.