Humerus fracture orif

[kmurp]

Working with a new surgeon tomorrow doing two humerus fractures. Not sure where the fractures are located nor her planned technique. We're I to do a block, would a supraclavicular cover it or would I need to add some local up at the C5 level as well.
I'm not sure how to get coverage of the whole humerus and shoulder if she is going to insert a rod from high up.
I'm thinking I would need GA as well as I wouldn't be certain of coverage.
Thoughts?

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[LivetoTell]

Most of the humerus fx I do are proximal fractures, so interscalene works great. If near the elbow, supraclavicular. We do generals, due to positioning (sitting) and draping. Most of the time, little or no narcotic is required.

 

[Urzuz]

Yes do GA as well. Regardless of how good your block is, you have no idea how long the new surgeon will take, and you don't want to end up doing a "heavy MAC" (GA without an airway) if your patient gets fidgety.

 

[Pooh & Annie]

I would want a general if I were getting rods crammed in my humerus(es?). Just because we CAN do neat stuff like surgical blocks doesn't always make it the right thing to do.

 

[Oggg]

Infraclavicular for distal humerus would be fine too

 

[kmurp]

These both turned out to be proximal fractures which the surgeon plated. I did ISB with GA and it worked out well. Thanks.