What are the nerves found in the Interscalene?
TABLE 2Distribution of the brachial plexus.
| Nerve(s) | Spinal Segment(s) | Distribution |
|---|---|---|
| Subclavius nerve | C4 through C6 | Subclavius muscle |
| Dorsal scapular nerve | C4–C5 | Rhomboid muscles and levator scapulae muscle |
| Long thoracic nerve | C5 through C7 | Serratus anterior muscle |
| Suprascapular nerve | C4, C5, C6 | Supraspinatus and infraspinatus muscles |
What is a Interscalene nerve block?
Interscalene nerve block refers to the placement of local anesthetic around the roots or trunks of the brachial plexus at the level of the C6 vertebral body between the anterior and middle scalene muscles. The procedure was first well described and popularized by Alon Winnie in 1970.
How long does Interscalene nerve block last?
The block can last anywhere from 4 to 18 hours, depending on which medicines are used. As with any anesthetic, there are risks and benefits to interscalene blocks.
What does the supraclavicular block cover?
The supraclavicular block is used for surgeries or postoperative pain control for the upper extremities. It is best for areas below the mid-humerus level. Above the mid-humerus, the shoulder area, an interscalene block would provide better coverage. However, if enough volume is used it can diffuse to the shoulder area.
Where does the interscalene block take place in the body?
This is to ensure the procedure occurs safely. The interscalene block is meant to target the brachial plexus, a network of nerves sectioned between two scalene muscles. These nerves send signals from the spine to the shoulder, arm and hand. To identify the area, the anesthesiologist will trace your nerves with a marker on your skin.
What are the side effects of an interscalene block?
recurrent laryngeal nerve blockade, or blocking the feeling of a significant nerve in the airway Horner syndrome, a rare condition that causes disruption of nerve pathways from the brain to the face and the eyes Other rare but severe interscalene block complications include: Preparing for an interscalene block?
Can a muscle twitch be caused by interscalene block?
Once they identify the nerves, they will attach a small needle to a handheld nerve stimulator in order to guide the numbing medication to the brachial plexus nerves. The handheld stimulator will cause a slight muscle contraction in the biceps or shoulder once the nerve has been activated. This muscle twitch does not cause any pain.
How is the interscalene brachial plexus block identified?
The following surface anatomy landmarks are important in identifying the interscalene space: FIGURE 5. Continuous interscalene brachial plexus block. The needle is inserted between anterior and middle scalene muscles in the pictured direction. The needle should not be placed deeper than 2-3 cm in most patients.