Cargando…

Inter Scalene Block: Revisiting old technique

BACKGROUND AND AIMS: The technique of percutaneous brachial plexus block has persisted in many variations since first such block given by Hirsheli in 1911.[1] Both supraclavicular and infraclavicular approaches have been described. Consequent to perivascular technique (Winnie and Collins 1964), Winn...

Descripción completa

Detalles Bibliográficos
Autores principales: Vaid, Vinendra Nath, Shukla, Aparna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020604/
https://www.ncbi.nlm.nih.gov/pubmed/29962595
http://dx.doi.org/10.4103/aer.AER_231_17
_version_ 1783335333193056256
author Vaid, Vinendra Nath
Shukla, Aparna
author_facet Vaid, Vinendra Nath
Shukla, Aparna
author_sort Vaid, Vinendra Nath
collection PubMed
description BACKGROUND AND AIMS: The technique of percutaneous brachial plexus block has persisted in many variations since first such block given by Hirsheli in 1911.[1] Both supraclavicular and infraclavicular approaches have been described. Consequent to perivascular technique (Winnie and Collins 1964), Winnie described interscalene block (ISB) in 1970.[23] Winnie's was a single deposit block which relied upon volume for its success. It is nearly 50 years that ISB has stood the test of time and has evolved from single to multiple deposits Block. In mid-90s, ultrasound guidance was first explored by anesthetists for regional anesthesia in University of Vienna.[3] As ultrasound guidance is becoming popular and is increasingly available to budding anesthetist, popularity of old technique has started waning. In this study, old technique of ISB was revisited with a view to assess its success rate with established drugs and examine if in light of ultrasound guidance, this technique has become irrelevant for anesthetist today. METHODS: A retrospective study, a survey with high response rate, was done on success rate of three variations of old technique of ISB in 100 patients. In variation-1, thirty patients received two deposits of local anesthetic in interscalene groove. In variation-2, thirty patients received four deposits of local anesthetic in interscalene groove. In variation-3, forty patients received six deposits of local anesthetic in interscalene groove along with infiltration of both scalene muscles. In none of the variations, paraesthesia was sought or peripheral nerve stimulator (PNS) or imaging gadget was used. Demographic data in three variations were compared statistically using Chi-square and one-way ANOVA test. Success rate among variations was analyzed by Fisher's exact test. RESULTS: In variation-1, 17 out of 30, in variation-2, 23 out of 30, and in variation-3, 37 out of 40 blocks were successful. CONCLUSION: Success of ISB given without PNS or ultrasound guidance is directly proportional to the number of deposits of local anesthetic made in interscalene groove.
format Online
Article
Text
id pubmed-6020604
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-60206042018-06-29 Inter Scalene Block: Revisiting old technique Vaid, Vinendra Nath Shukla, Aparna Anesth Essays Res Original Article BACKGROUND AND AIMS: The technique of percutaneous brachial plexus block has persisted in many variations since first such block given by Hirsheli in 1911.[1] Both supraclavicular and infraclavicular approaches have been described. Consequent to perivascular technique (Winnie and Collins 1964), Winnie described interscalene block (ISB) in 1970.[23] Winnie's was a single deposit block which relied upon volume for its success. It is nearly 50 years that ISB has stood the test of time and has evolved from single to multiple deposits Block. In mid-90s, ultrasound guidance was first explored by anesthetists for regional anesthesia in University of Vienna.[3] As ultrasound guidance is becoming popular and is increasingly available to budding anesthetist, popularity of old technique has started waning. In this study, old technique of ISB was revisited with a view to assess its success rate with established drugs and examine if in light of ultrasound guidance, this technique has become irrelevant for anesthetist today. METHODS: A retrospective study, a survey with high response rate, was done on success rate of three variations of old technique of ISB in 100 patients. In variation-1, thirty patients received two deposits of local anesthetic in interscalene groove. In variation-2, thirty patients received four deposits of local anesthetic in interscalene groove. In variation-3, forty patients received six deposits of local anesthetic in interscalene groove along with infiltration of both scalene muscles. In none of the variations, paraesthesia was sought or peripheral nerve stimulator (PNS) or imaging gadget was used. Demographic data in three variations were compared statistically using Chi-square and one-way ANOVA test. Success rate among variations was analyzed by Fisher's exact test. RESULTS: In variation-1, 17 out of 30, in variation-2, 23 out of 30, and in variation-3, 37 out of 40 blocks were successful. CONCLUSION: Success of ISB given without PNS or ultrasound guidance is directly proportional to the number of deposits of local anesthetic made in interscalene groove. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6020604/ /pubmed/29962595 http://dx.doi.org/10.4103/aer.AER_231_17 Text en Copyright: © 2018 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Vaid, Vinendra Nath
Shukla, Aparna
Inter Scalene Block: Revisiting old technique
title Inter Scalene Block: Revisiting old technique
title_full Inter Scalene Block: Revisiting old technique
title_fullStr Inter Scalene Block: Revisiting old technique
title_full_unstemmed Inter Scalene Block: Revisiting old technique
title_short Inter Scalene Block: Revisiting old technique
title_sort inter scalene block: revisiting old technique
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020604/
https://www.ncbi.nlm.nih.gov/pubmed/29962595
http://dx.doi.org/10.4103/aer.AER_231_17
work_keys_str_mv AT vaidvinendranath interscaleneblockrevisitingoldtechnique
AT shuklaaparna interscaleneblockrevisitingoldtechnique