Ultrasound Guided Low Approach To Interscalene Brachial Plexus Block "Spinal Anaesthesia of The Upper Extremity"
Ultrasound Guided Low Approach To Interscalene Brachial Plexus Block - "Spinal Anaesthesia of The Upper Extremity"
Keywords:
Interscalene brachial plexus block; Ultrasoundguided; Upper limb surgeryAbstract
Background: Interscalene Brachial plexus block is not widely used these days due to its complications and it is not appropriate in upper limb surgeries because it does not affect the lower trunk (C8−T1, ulnar nerve) of the brachial plexus. Methods: A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on one hundred and twelve patients undergoing surgery of the upper extremities. The patients were assessed after the block for the degree of block in each nerve and muscle as well as for any complications. Results: The patients were assessed after the block for the degree of block in each nerve and muscle as well as for any complications. We observed complete sensory and motor block in all the nerves in all the 112 patients. None of the patients received additional analgesics, and none experienced complications. Conclusions: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve with no complications. [Darshana S NJIRM 2017; 8(6):16-19]
References
2. Ultrasonographic guidance improves the success rate of interscalene brachial plexus blockade. Kapral S, Greher M, Huber G, Willschke H, Kettner S, Kdolsky R, Marhofer P. Reg Anesth Pain Med 2008;33:253-8.
3. Applying ultrasound imaging to interscalene brachial plexus block. Chan VW: Reg Anesth Pain Med 2003; 28: 340-3.
4. Kim JH, Chen J, Bennett H, Lesser JB, Resta-Flarer F, Barczewska-Hillel A, et al. A low approach to interscalene brachial plexus block results in more distal spread of sensory-motor coverage compared to the conventional approach. Anesth Analg 2011; 112: 987-9
5. Burckett-St Laurent D, Chan V, Chin KJ. Refining the ultrasound-guided interscalene brachial plexus block: the superior trunk approach. Can J Anaesth 2014; 61: 1098- 102.
6. Bharti N, Bhardawaj N, Wig J. Comparison of ultrasound- guided supraclavicular, infraclavicular and below-C6 interscalene brachial plexus block for upper limb surgery: a randomised, observer-blinded study. Anaesth Intensive Care 2015; 43: 468-72.
7. Renes SH, Rettig HC, Gielen MJ, Wilder-Smith OH, van Geffen GJ. Ultrasound-guided low-dose interscalene brachial plexus block reduces the incidence of hemidiaphragmatic paresis. Reg Anesth Pain Med 2009; 34: 498-502.
8. Plante T, Rontes O, Bloc S, Delbos A. Spread of local anesthetic during an ultrasound-guided interscalene block: does the injection site influence diffusion? Acta Anaesthesiol Scand 2011; 55: 664-9.
