title: Posterior interscalene block: an ultrasound-guided case series and overview of history, anatomy and techniques.
abstract: 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.
authors.affiliation: Department of Anesthesia, Sunnybrook Health Sciences Centre and Holland Orthopedic and Arthritic Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: McNaught
authors.forename: Paul
authors.initials: P
authors.lastname: McHardy
authors.forename: Imad T
authors.initials: IT
authors.lastname: Awad
mesh_terms: 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
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010098:Oxycodone
references.citation: Anaesthesia. 2006 Jun;61(6):591-2
references.pmid: 16704597
references.citation: Anaesthesia. 2006 Nov;61(11):1105-8
references.pmid: 17042851
references.citation: Reg Anesth Pain Med. 2003 Jan-Feb;28(1):70-1
references.pmid: 12567350
references.citation: Anesth Analg. 2005 May;100(5):1496-1498
references.pmid: 15845713
references.citation: Reg Anesth Pain Med. 2006 Jul-Aug;31(4):388-9
references.pmid: 16857562
references.citation: Reg Anesth Pain Med. 2007 Nov-Dec;32(6):481-7
references.pmid: 18035293
references.citation: Reg Anesth Pain Med. 2006 Mar-Apr;31(2):119-26
references.pmid: 16543097
references.citation: Anesth Analg. 1970 May-Jun;49(3):455-66
references.pmid: 5534420
references.citation: Reg Anesth Pain Med. 2009 Jan-Feb;34(1):64-8
references.pmid: 19258990
references.citation: Anaesthesia. 2007 Oct;62(10):1024-8
references.pmid: 17845654
references.citation: Anaesthesia. 2006 Nov;61(11):1028-30
references.pmid: 17042838
references.citation: Eur J Anaesthesiol. 1992 May;9(3):235-9
references.pmid: 1600975