title: Ultrasound Guided Low Approach Interscalene Brachial Plexus Block for Upper Limb Surgery.
abstract: BACKGROUND
  The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus.
  
  
  METHODS
  A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications.
  
  
  RESULTS
  At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be 2.8 ± 2.6 and 1.1 ± 1.8, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications.
  
  
  CONCLUSIONS
  The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea.
authors.forename: Sun Kyung
authors.initials: SK
authors.lastname: Park
authors.affiliation: Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Min Ha
authors.initials: MH
authors.lastname: Sung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea.
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Suh
authors.affiliation: Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea.
authors.forename: Yun Suk
authors.initials: YS
authors.lastname: Choi
keywords: Complication; Interscalene brachial plexus block; Nerve stimulator; Sensory block; Ultrasound-guided; Upper limb surgery
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