Interscalene block for mediport

Started by Maverikk
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Maverikk

Maverikk

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Would this be useful, surgeon inquired about it and it seems like it would cover the area and reduce the need for as deep sedation when you have a surgeon who doesn't localize well. I was thinking mepivacaine for speed of onset and procedure. Thoughts?
 
Pecs-1blockerPecsblock-e1453196533108.jpg
 
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PECS1 would work too, probably better coverage but interscalene should cover C5, it would be the C4 that would be the problem...probably needs less local by the surgeon either way
 
Maverikk said:
PECS1 would work too, probably better coverage but interscalene should cover C5, it would be the C4 that would be the problem...probably needs less local by the surgeon either way
Click to expand...


Ultrasound Guided PECS Block PECS 1 Blocks:
• Median pectoral nerve(C8,T1)
Lateral pectoral nerve(C5,C6,C7).
Blocked between Pectoralis Major and minor
 
Maverikk said:
PECS1 would work too, probably better coverage but interscalene should cover C5, it would be the C4 that would be the problem...probably needs less local by the surgeon either way
Click to expand...

sure less local by the surgeon after you already injected a bunch of local.

How bad is the surgeon that they want a nerve block for a port? I mean it's a central line with a little tunnel and a pocket. Putting an IJ in an even mildly sedated patient is not difficult, hell it isn't difficult in an unsedated patient.
 
soorg said:
Unbelievable overkill. Why not do a spinal for a pinky toe amputation while you're at it?
Click to expand...

I think it's more akin to placing a cervical epidural for post-thyroidectomy pain control 😉
 
Yeah IS for a mediport sounds stupid. PECS is semi reasonable but really overkill when they can just field block and be done with it.

On the upside, at least your surgeon is into blocks as a concept...
 
Def seems like overkill. Is the goal to avoid all sedation? Outside of difficult airways, an IS would be relatively contraindicated in someone you might want to avoid sedation like a severe COPDer
 
Definitely overkill, I did like that they realized the advantages to blocks..Don't think I'd do it though, seems like a procedure that risks/benefits don't weigh out given they can just use local
 
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