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[Ultrasound-guided interscalene block: Influence of anatomic variations in clinical practice]

OBJECTIVES: This study aimed to evaluate visibility of interscalenic brachial plexus (IBP) variations with ultrasonography (US). Secondary end-point compared success rate of the interscalene block (IB) in shoulder surgery with or without the presence of variation. STUDY DESIGN: Retrospective descriptive study, conducted in two University Departments of Anesthesiology. PATIENTS AND METHODS: One hundred and forty-six (27 volunteers and 46 patients) high-resolution US of interscalene region were reviewed. Single shot IB in 46 patients were analyzed over the first 30 minutes comparing groups with variation or not. RESULTS: Forty-nine percent (71/146) regions presented at least one visible variation by US. Thirty-three percent (48/146) showed an intramuscular passage of a root, 8% (12/146) showed a C5 root ahead of the anterior scalene muscle and 23% (33/146) an artery crossing the roots or trunks. Thirty-seven percent (54/146) presented an artery close to the plexus which could be close to the needle. In the forty-six IB performed, the presence of a variation did not show any difference in the sensitive and motor blocks at the 30th minute (p>0.05). CONCLUSION: The high-resolution cervical US highlights the IBP variations. These variations appear not to have any relevant influence on the performance of the single shot IB

Keywords : administration & dosage,Adult,Aged,anatomy & histology,Anesthetics,Local,Arteries,Brachial Plexus,diagnostic imaging,Diffusion,drug effects,Efferent Pathways,Female,France,Humans,Injections,Intramuscular,Jugular Veins,Male,methods,Middle Aged,Muscle,Skeletal,Nerve Block,Orthopedic Procedures,pharmacokinetics,Retrospective Studies,Shoulder,Spinal Nerve Roots,surgery,Ultrasonography,, Interscalene,Block,Influence,Anatomic, harley street station

Date of Publication : 2010 Nov

Authors : Gutton C;Choquet O;Antonini F;Grossi P;

Organisation : Service d’anesthesie-reanimation, hopital la Conception, CHU de Marseille, 147, boulevard Baille, 13385 Marseille cedex 5, France. christophe.gutton@ap-hm.fr

Journal of Publication : Ann Fr Anesth Reanim

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20934304

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