Interscalene Brachial Plexus Block

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Interscalene Brachial Plexus Block

Рет қаралды 132,037

Regional Anesthesiology and Acute Pain Medicine

Күн бұрын

In this video we discuss the technique for ultrasound guided interscalene brachial plexus block, as well as the indications, challenges, and key safety tips relevant to this block procedure

Пікірлер: 18

@eugeniosramos 3 жыл бұрын

Amazing video. I'm an incoming anesthesia trainee and will keep coming to these videos. Thanks

@batman-sr2px 9 ай бұрын

What black is used for teres major?

@bachraouichiraz1164 3 жыл бұрын

Is the sheath not an obstacle neither for the L. A to diffuse, in supraclavicular block too?

@suvarnatamaskar465 3 жыл бұрын

Very well explained.

@tl854393 Жыл бұрын

Great video! For proximal humerus fracture, I often miss the incision with ISB block, which block can we add to cover the incision, sir?

@freestylie Жыл бұрын

I combine with supraclavicular (or could likely do with an infra/costoclavicular) if any distal humerus work - have found if intermedullary nail in distal humerus interscalene can miss this, for a very proximal and medial incision t1-3 innervation from intercostobrachial can be an issue. The subcut injection of local for the intercostobrachial nerve can help (or use ultrasound - I honestly cant normally see the nerve but it runs on top of the conjoint tendon above latissimus dorsi and so I tend to put some volume in this facial plane (from a slightly more posterior probe placement than a stardard "axillary" brachial plexus block) in the armpit.

@oliviaolivia7011 3 жыл бұрын

Why in plane and not out of plane interscalene which doesn’t have a risk of damaging long thoracic and dorsal scapular also easier to insert a catheter ...

@williamtellez6660 Жыл бұрын

What are your thoughts on replacing the IBS block with the Superior Trunk Block?

@lisaeadesauthorandartist 2 жыл бұрын

I went to get an interscalene block done the other day, but ended up being told I couldn't get it done due to my nerves being too inflamed and it would in turn make it worse 😞 My scalene muscles are fused to the c5, c6, c7 and part of the c8 nerve roots apparently. Very frustrating.

@02hreblue30 Жыл бұрын

nice video

@harounism 3 жыл бұрын

Thanks

@angelaclark5916 3 жыл бұрын

A surgeon has advised me to get an "interscalene block under ultra sound" for diagnostic purposes of pain in my right arm and upper back. The surgeon wants this block for diagnosing possible neurogenic thoracic outlet syndrome or some other nerve entrapment within my brachial plexus that causes my pain which travels along the dorsal scapular nerve, with burning along the scapular medial border & rhomboids as well as burning on my posterior arm/triceps and then numbness in 4th and 5th fingers. He is considering a scalenectomy of middle and anterior scalene if the block relieves there pain. Or some other peripheral nerve surgery. Can you tell me what type of nerve block would include the DSN? I'm concerned that a standard interscalene block will not block the DSN, therefore making this particular block somewhat missing the main suspected pain generator. Please advise what would include the DSN. Thank you

@lisaeadesauthorandartist 2 жыл бұрын

Can you let me know how you ended up going with your procedure and if you ended up having surgery? I am getting an interscalene block for NTOS coming up in the next couple weeks. Similar symptoms to you, my neck and ear burns when it's irritated, nerve pain down my arm, elbow and into all my fingers creating pins and needles. Originally was being treated for bursitis and impingement before it progressed into nerve pain. If the block doesn't work then I've been told I'd need "Scalene Lysis" surgery.

@angelaclark5916 2 жыл бұрын

@@lisaeadesauthorandartist Hi Lisa. The block did help alleviate some of the pain. I decided to continue with injections w/steroid to control pain. It works well enough to keep me out of surgery and able to do my job. It wore off after 5 months and I got another injection. Still going ok with that one. If I can manage pain to tolerable level with these injections into the scalenes, I will put off surgery. Please let me know how your procedure works.

@lisaeadesauthorandartist 2 жыл бұрын

@@angelaclark5916 I'm so glad the block worked for you! I went to get my block done the other day, but unfortunately ended up being told my nerves are too inflamed to have it done. He proceeded to do an ultrasound and took some pictures of my scalene muscles that are fused to the c5, c6, c7 and partially to the c8 nerve roots. Was told if he gave the interscalene block it would essentially make my condition worse. If my nerves can settle down within the next couple of weeks then he will see if he can do a botox injection instead, before I see the orthopaedic surgeon. It's progressively getting worse for me unfortunately and I can't do my job at all until it gets sorted. Have been told it'll be months not weeks for a fix.

@angelaclark5916 2 жыл бұрын

@@lisaeadesauthorandartist oh Lisa! I am so sorry. Hug to you. That is a very difficult situation you have. Can I message you some place? Are you on Facebook messenger?

@taraengstrom8704 11 ай бұрын

@@lisaeadesauthorandartistdo you know what caused your initial inflammation? How are you doing a year later? Dealing with something similar but can’t get a diagnosis