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Inter Scalene Block: Revisiting old technique.

Vinendra Nath Vaid1, Aparna Shukla1

  • 1Department of Anaesthesia, Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, India.

Anesthesia, Essays and Researches
|July 3, 2018
PubMed
Summary
This summary is machine-generated.

The success of interscalene block (ISB) without ultrasound or nerve stimulation is directly related to the number of local anesthetic injections. More deposits in the interscalene groove lead to a higher success rate for this regional anesthesia technique.

Keywords:
Brachial plexus blockinterscalene blocksupraclavicular block

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Area of Science:

  • Anesthesiology
  • Regional Anesthesia
  • Surgical Procedures

Background:

  • The interscalene block (ISB) is a long-standing regional anesthesia technique with various modifications since its inception in 1911.
  • Historically, ISB relied on volume for success, evolving from single to multiple injections.
  • The advent of ultrasound guidance in the mid-1990s has led to a decline in the popularity of traditional ISB techniques.

Purpose of the Study:

  • To reassess the efficacy of the traditional, non-ultrasound-guided interscalene block.
  • To evaluate the success rate of ISB using established anesthetic agents.
  • To determine if the traditional ISB technique remains relevant for anesthesiologists in the era of ultrasound guidance.

Main Methods:

  • A retrospective study involving 100 patients was conducted to assess three variations of the traditional ISB technique.
  • Variation 1: 30 patients received two local anesthetic deposits.
  • Variation 2: 30 patients received four local anesthetic deposits.
  • Variation 3: 40 patients received six local anesthetic deposits with infiltration of scalene muscles.
  • No paraesthesia, peripheral nerve stimulator (PNS), or imaging was used; demographic data and success rates were statistically analyzed.

Main Results:

  • Variation 1 (2 deposits) had a success rate of 17/30.
  • Variation 2 (4 deposits) had a success rate of 23/30.
  • Variation 3 (6 deposits) had a success rate of 37/40.

Conclusions:

  • The success rate of interscalene blocks performed without peripheral nerve stimulation or ultrasound guidance is directly proportional to the number of local anesthetic deposits.
  • Increasing the number of injections in the interscalene groove enhances the efficacy of the traditional ISB technique.