What is the difference between Interscalene and supraclavicular block?
The increased distance between the supraclavicular injection site and the phrenic nerve compared with the interscalene approach results in a reduced incidence of hemidiaphragmatic paresis. The shoulder joint is mainly innervated by the suprascapular and axillary nerves originating from the brachial plexus.
Where is the Interscalene nerve?
Interscalene nerve block refers to the placement of local anesthetic around the roots or trunks of the brachial plexus at the level of the C6 vertebral body between the anterior and middle scalene muscles.
What is Interscalene Anaesthesia?
An interscalene block is an anesthetic technique. It’s used as a regional anesthetic, and may be combined with a general anesthetic, to block sensations in the shoulder and upper arm before, during, and after surgery.
Is supraclavicular block good for shoulder surgery?
Supraclavicular block (SCB) has been suggested to provide effective anaesthesia for shoulder surgery with a low rate of adverse events [6], [7]. Anatomically, the shoulder is also innervated by the suprascapular nerve within the supraclavicular fossa.
What is the most commonly reported complication in the use of Interscalene regional anesthesia for shoulder surgery?
Other concerns about the routine use of interscalene blocks for shoulder surgery are due to the variable rate of successful block placement, from 84% to 98% according to case series (5, 6), and the possibility of major complications, including inadvertent spinal/epidural anaesthesia, seizure and cardiac arrest (7).
How do you palpate with Interscalene groove?
To locate the bra- chial plexus at the supraclavicular level, gently palpate the interscalene groove down to the mid- point of the clavicle (Figure 8-3). Note that the groove can occasionally be ob- scured near the clav- icle by the omohyoid muscle.
What is Interscalene brachial plexus?
The interscalene block (ISB) anesthetizes the brachial plexus at the level of the nerve roots, and is used for surgery of the upper arm, shoulder, and neck. The brachial plexus is formed by the ventral rami of the lower cervical and upper thoracic nerve roots (figure 1).
What does supraclavicular block coverage?
The supraclavicular block is used for surgeries or postoperative pain control for the upper extremities. It is best for areas below the mid-humerus level. Above the mid-humerus, the shoulder area, an interscalene block would provide better coverage. However, if enough volume is used it can diffuse to the shoulder area.
How long does Interscalene nerve block last?
The block can last anywhere from 4 to 18 hours, depending on which medicines are used. As with any anesthetic, there are risks and benefits to interscalene blocks. These particulars can be discussed with your anesthesiologist before your surgery.