Scalene blocks

[roja]

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This is spurred from a discussion thread on one of our EM forums:


Anybody use scalene blocks for extremeties reductions, etc? I have only seen one done in anesth (without a nerv stimulator). However, one attending said he had gas come down and do one on another attending with a fractured arm.



this has also led to discussions on intraarticular injections of shoulders for reduction...



discuss....

 

[jf]

What are your thoughts on intraarticular injections/scalene blocks vs. conscious sedation for shoulder reductions. Risk vs benefit, etc.?

 

[jdig]

What are your thoughts on intraarticular injections/scalene blocks vs. conscious sedation for shoulder reductions. Risk vs benefit, etc.?

Let me say this about scalene blocks. Make sure the nurse anesthethist doesnt put you under general BEFORE giving you the block. I was in for an open acromioplasty and the crna did just that. He lacerated the posterior cord because w/o feedback he didnt know where the he11 he was and I ended up with NO deltoid or spinatii firing for 6 months. It took bp surgery to correct, but only deltoid has come back thus far (7 mos post). Needless to say, I am not a fan of the procedure. Sucks to lose function of your right arm when you are right handed.

 

[DrQuinn]

This is spurred from a discussion thread on one of our EM forums:


Anybody use scalene blocks for extremeties reductions, etc? I have only seen one done in anesth (without a nerv stimulator). However, one attending said he had gas come down and do one on another attending with a fractured arm.



this has also led to discussions on intraarticular injections of shoulders for reduction...



discuss....

Never done a scalene block but I have done intraarticular injections for shoulder reductions (two under my belt). They work great. Its a septic technique and all, just make sure you talk to the patient about risks/benefits and document well. I love shoulder reductions cause there are so many different ways to do them!

Q