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A supraomohyoidal plexus block designed to avoid complications.

G Feigl1, A Fuchs, M Gries

  • 1Department of Anatomy, Medical University Graz, Graz, Austria. Georg.Feigl@medecine.unige.ch

Surgical and Radiologic Anatomy : SRA
|May 9, 2006
PubMed
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The supraomohyoidal block offers a safer alternative to interscalene blocks for shoulder surgery by avoiding medial spread. This technique minimizes risks like phrenic nerve palsy and Horner syndrome, with 20 ml solution proving sufficient.

Area of Science:

  • Anatomy
  • Regional Anesthesia
  • Surgical Procedures

Background:

  • Interscalene blocks are standard for shoulder surgery but carry risks like phrenic nerve block and Horner syndrome.
  • Minimizing these complications is crucial for patient safety and procedural success.

Purpose of the Study:

  • To introduce and evaluate a novel supraomohyoidal block technique for brachial plexus anesthesia.
  • To assess the safety and efficacy of this approach by comparing it to the traditional interscalene block.

Main Methods:

  • The supraomohyoidal block was performed on 11 Thiel-embalmed cadavers, with solution distribution analyzed via dissection and CT scans.
  • Needle insertion was lateral to the sternocleidomastoid muscle, advancing laterally and caudally.
  • A comparative analysis was conducted with Winnie's interscalene block technique in five additional cadavers.

Related Experiment Videos

Main Results:

  • The supraomohyoidal block consistently spread to the infraclavicular region, encompassing brachial plexus trunks and the suprascapular nerve.
  • Crucially, the injected solution remained lateral to the anterior scalene muscle, avoiding the phrenic nerve, stellate ganglion, and vertebral artery.
  • Winnie's technique demonstrated medial spread beyond the anterior scalene muscle.

Conclusions:

  • The supraomohyoidal block is a potentially safer alternative to interscalene blocks, significantly reducing the risk of adverse events.
  • A 20 ml solution volume appears adequate for effective anesthesia with this technique.
  • This method offers targeted brachial plexus anesthesia with enhanced safety profile.