Nerve block: Intrascalene: Difference between revisions

(Text replacement - "* " to "*")
No edit summary
Line 1: Line 1:
==Overview==
==Overview==
An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.<ref>Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080</ref>  
*An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.<ref>Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080</ref>  
 
==Indications==
==Indications==
*Post operative analgesia for shoulder surgery
*Post operative analgesia for shoulder surgery
Line 28: Line 29:
*[[Pneumothorax]]<ref>Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.</ref>
*[[Pneumothorax]]<ref>Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.</ref>
**On the side of the nerve block
**On the side of the nerve block
==See Also==
==See Also==
*[[Nerve Blocks]]
*[[Nerve blocks (main)]]
 
==External Links==
==External Links==
Great instructional page from Highland on the intrascalene nerve block
*http://highlandultrasound.com/interscalene-block/
http://highlandultrasound.com/interscalene-block/


==References==
==References==
<references/>
<references/>


[[Category:Procedures]][[Category:Ultrasound]]
[[Category:Procedures]]
[[Category:Ultrasound]]

Revision as of 00:05, 25 December 2016

Overview

  • An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.[1]

Indications

  • Post operative analgesia for shoulder surgery
  • Humerus fracture
  • Lacerations or abscesses of upper arm and deltoid

Contraindications

  • Severe lung disease
    • Due to risk of unilateral pneumothorax
  • Overlying infection
  • Allergy to anesthetics
  • Phrenic nerve dysfunction
    • Specifically contralateral phrenic nerve dysfunction, due to the risk of unilateral paralysis

Equipment Needed

  • Linear Probe
  • 25 g needle
  • 5-10cc local anesthetic

Procedure

  • Always check for the transverse cervical artery using color Doppler.
  • Keep needle tip as far from the nerve roots as possible.
  • Assume phrenic paralysis and avoid in patients with tenuous respiratory status.

Complications

  • Phrenic nerve dysfunction[2]
    • Causing unilateral diaphragmatic paralysis and respiratory distress.
  • Pneumothorax[3]
    • On the side of the nerve block

See Also

External Links

References

  1. Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080
  2. Borgeat A et al. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct. 95(4):875-80
  3. Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.