Patient 30 degrees head-up
At edge of bed. Pillow pushed.
Neck rotated slightly away.
Can stand north or south.
From supraclavicular region.
Identify subclavian artery pulsating. Identify brachial plexus nerves superior/lateral/posterior.
SCAN cephalad to identify roots (C5,6,7) between anterior and medial scalene
Approach from posteriorly. 50mm simplex needle
20ml of 0.375% for analgesia, 0.5% + lignocaine for anaesthesia