Interscalene Brachial Plexus Block

Winnie, Alon P.

doi:10.1213/00000539-197005000-00029

Cited by 537 publications

(239 citation statements)

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“…Interscalene block was performed using Winnie's approach [3] and a nerve stimulator (Stimuplex HNS 11; B Braun, Freiburg, Germany; Contiplex Tuohy 1.5¢¢ ⁄ 18-G; B Braun). Biceps muscle contraction was obtained and then disappeared below a current level of 0.3 mA.…”

Section: Case Reportmentioning

confidence: 99%

Catastrophic complication of an interscalene catheter for continuous peripheral nerve block analgesia

et al. 2012

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Summary We report a catastrophic postoperative complication of a prolonged interscalene block performed under general anaesthesia. The course of the anaesthetic was uneventful and the patient remained stable during his stay in the recovery area with the operative extremity paralysed and insensate. No further local anaesthetic was administered until later that day when the patient received 10 ml bupivacaine 0.25% through the catheter. Upon completion of the top‐up dose, no change in the patient’s status was noticed. The patient was next assessed 6.5 h later when he was found dead in his bed. A postmortem CT scan revealed the catheter to be sited intrathecally, presumably the result of dural sleeve penetration.

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Section: Case Reportmentioning

confidence: 99%

Catastrophic complication of an interscalene catheter for continuous peripheral nerve block analgesia

et al. 2012

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“…Alon Winnie in 1970 described the percutaneous technique of palpating and injecting local anesthetic into the groove between the anterior and middle scalene muscles at the level of the cricoid cartilage. This was a truly effective, technically simple, and safe means of anesthetizing the brachial plexus [8]. Subsequently, interscalene brachial plexus block (interscalene block) has significantly gained in popularity.…”

Section: Regional Block Anesthesiamentioning

confidence: 99%

“…Immediately lateral to the transverse processes of the cervical vertebrae the nerve roots that eventually form the brachial plexus are enveloped within a common fascial sheath -an important concept when considering complete anesthesia to the shoulder. 8 Winnie has stated that the fascial sheath may be entered at any level from the cervical nerve roots to the distal axilla in a manner analogous to the performance of epidural analgesia. The resultant spread of local anesthetic induced analgesia will therefore be dependent upon the level entered and the volume and concentration of local anesthetic solution injected.…”

Section: Brachial Plexus Anatomy and Shoulder In-nervationmentioning

confidence: 99%

Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia

Ghaleb¹,

Dilley²

2012

TOATJ

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A review of the literature regarding anesthesia for shoulder surgery was performed. Current anesthetic techniques available include regional, general, or a combination of regional and general. We discuss each of these techniques, with an emphasis on regional (specifically interscalene block), in detail. Current evidence supports both regional and general anesthesia to be safe and efficient techniques. The interscalene block is considered by most to provide the best surgical anesthesia and is the most commonly performed block for shoulder surgery. This paper aims to review the performance of the interscalene block and to discuss alternative choices for shoulder surgery, namely general anesthesia and a combined general/regional technique. We also aim to provide considerations to aid in the performance of a safely administered anesthetic.

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“…The procedure was first well described and popularized by Alon Winnie in 1970. [3] Interscalene nerve block is typically performed to provide anesthesia and analgesia for surgery of the shoulder and upper arm. [4][5][6] Bupivacaine 0.5% has been most frequently used as local anesthetic agent for brachial plexus block for many years because of its favorable ratio of sensory to motor neural block and longer duration of action.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Ropivacaine 0.5% with fentanyl and Bupivacaine 0.5% with fentanyl in Interscalene Brachial Plexus Block

Barsagade¹,

Tarkase²,

Gate³

2016

Int J of Biomed & Adv Res

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Aim and Objective: Aim of the present study was to compare the clinical characteristics of ropivacaine 0.5% and bupivacaine 0.5% with fentanyl when used for interscalene brachial plexus block. Methodology: In this prospective randomized double blind study, 60 patients were randomly divided into two groups, group BF-bopivacaine with fentanyl and group RF-ropivacaine with fentanyl. Effects in terms of onset, duration and quality of sensory and motor blockade, pulse and blood pressure, respiration were monitored and complications of interscalene brachial plexus block were also noted. Results: The mean onset time of sensory and motor blockade was 2.65 and 4.31 minutes in group BF and 4.08 and 6.08 minutes in group RF group respectively. The mean duration of sensory and motor block was 644.44 min and 595.55 min in group BF respectively. Whereas, in group RF the mean duration of sensory and motor block was 573.46 min and 513.46 min respectively. Mean VAS preoperatively was comparable among two groups perioperatively and till 7 hr after block placement (p> 0.05) all patient depicted a VAS score 0 up to 6 hr. The requirement of rescue analgesic was earlier with ropivacaine as compared to bupivacaine. Conclusion: Ropivacaine has the margin of safety than bupivacaine. Ropivacaine with an almost comparable blockade profile would be the better choice in view of safety of the patient.

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Interscalene Brachial Plexus Block

Cited by 537 publications

References 0 publications

Catastrophic complication of an interscalene catheter for continuous peripheral nerve block analgesia

Catastrophic complication of an interscalene catheter for continuous peripheral nerve block analgesia

Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia

Comparative Study of Ropivacaine 0.5% with fentanyl and Bupivacaine 0.5% with fentanyl in Interscalene Brachial Plexus Block

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