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A Brief Overview of the Interscalene Nerve Block

A Brief Overview of the Interscalene Nerve Block. Meghan Hughes. What?. A procedure in which an anesthetic agent is injected around the peripheral nerves of the brachial plexus in order to anesthetize the shoulder, lateral arm and lateral forearm

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A Brief Overview of the Interscalene Nerve Block

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  1. A Brief Overview of the Interscalene Nerve Block Meghan Hughes

  2. What? • A procedure in which an anesthetic agent is injected around the peripheral nerves of the brachial plexus in order to anesthetize the shoulder, lateral arm and lateral forearm • Usually for pain control or anesthesia during surgery

  3. Why? • Anesthesia during orthopedic surgeries of the shoulder and arm and post operative pain relief • Pain relief post amputation • Analgesia following limb ischemia, trauma, etc • Reduction of dislocated shoulders in the ED

  4. How: • Position the patient • Identify landmarks • Using sterile technique, inject local anesthetic • Insert the needle using U/S or a nerve stimulator to ensure proper positioning • Inject anesthetic

  5. Tips and tricks • Positioning • The addition of magnesium sulfate or dexamethasone prolongs analgesia post op

  6. Side Effects and Complications • Damage to nerves or blood vessels • Infection • Horner’s Syndrome

  7. Resources • VanNorman GA. Interscalene Nerve Block. Procedures Consult. (2010). Retrieved from http://app.proceduresconsult.com.libproxy.tulane.edu:2048/Learner/projects/FullDetails.aspx?ProcedureId=271&procSN=AN-023#0 • Blaivas M, Adhikari S, Lander L. A Prospective Comparison of Procedural Sedation and Ultrasound-guided Interscalene Nerve Block for Shoulder Reduction in the Emergency Department. Academic Emerg Med. (2011) 18 (9): 922-927.10.1111/j.1553-2712.2011.01140.x • Cummings KC, et al. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. Br J Anesth. (2011) 107 (3): 446-453. DOI 10.1093/bja/aer159 • Le AR, et al. Magnesium added to bupivacaine prolongs the duration of analgesia after interscalene nerve block. Can J Anesth. (2012) 59:21–27. DOI 10.1007/s12630-011-9604-5 • http://en.wikipedia.org/wiki/Brachial_plexus • http://www.bats.ac.nz/resources/interscalene.php

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