Posterior interscalene block: an ultrasound-guided case series and overview of history, anatomy and techniques.
BACKGROUND
The posterior interscalene block has been described as an alternative to the lateral interscalene block. However, this technique has not gained popularity because of the close proximity of the approach to vascular and central neural structures.


OBJECTIVE
To describe the posterior interscalene block technique using ultrasound imaging, and to review the history of its evolution.


METHODS
The use of ultrasound imaging to facilitate the insertion of interscalene catheters using the posterior approach in 11 patients undergoing total shoulder arthroplasty is described.


RESULTS
All 11 patients had satisfactory analgesia in the first 24 h of the postoperative period. None of the patients complained of neck pain, as had been found in earlier techniques using the posterior approach.


CONCLUSIONS
This modification of the posterior approach is a safe and effective method for the insertion of interscalene brachial plexus catheters. These catheters are also comfortable for patients and, in the present study, none of the catheters inadvertently fell out.
McNaught
Andrew
A
Department of Anesthesia, Sunnybrook Health Sciences Centre and Holland Orthopedic and Arthritic Centre, University of Toronto, Toronto, Ontario, Canada.
McHardy
Paul
P
Awad
Imad T
IT
D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001917:Brachial Plexus / Q000000981:diagnostic imaging*; D004558:Electric Stimulation / Q000379:methods; D006801:Humans; D019547:Neck Pain / Q000188:drug therapy / Q000628:therapy*; D009407:Nerve Block / Q000379:methods*; D010098:Oxycodone / Q000627:therapeutic use; D010147:Pain Measurement; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010098:Oxycodone
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