Nerve block: Intrascalene: Difference between revisions
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*[[Humerus fracture]] | *[[Humerus fracture]] | ||
*Lacerations or abscesses of upper arm and deltoid | *Lacerations or abscesses of upper arm and deltoid | ||
*Shoulder dislocation | |||
==Contraindications== | ==Contraindications== | ||
Revision as of 02:39, 9 April 2017
Overview
- Provides anesthesia to the shoulder and upper arm.[1]
Indications
- Post operative analgesia for shoulder surgery
- Humerus fracture
- Lacerations or abscesses of upper arm and deltoid
- Shoulder dislocation
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
- Ultrasound (linear probe)
- Syringe with 25g 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
- ↑ 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
- ↑ 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
- ↑ Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.