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I have a new locums who says that he can cover the pain from shoulder arthoscopy with a supraclavicular block, I have read it will not but books do not tell everything anyone else doing this?
Ditto on why one would choose supraclavicular over interscalene. Enough propofol during the procedure will ensure the supra scapular nerve is blocked! A superficial cervical plexus block would also be needed; and the surgeon should still give some local at the sites.
Anyway, I won't do a suprascapular without ultrasound; that pesky lung is just too close.
More importantly, why did zonker1 get banned?
-copro
True,Suprascap only gets the posterior 50% of the AC joint, and not that much of the more lateral RC. To get complete (or near complete) AC and prox RC, you need to also get the lateral articular branch of the pectoral nerve. We're actually working on this block with some phenomenal results in the SAD's.
Oh, thanks for clarifying.supraclavicular
not suprascapular
Ultrasound guided supraclavicular block is all you need for any type of upper extremity surgery including shoulder surgery. I routinely do even shoulder replacements with just this block and moderate sedation -yes, that means no GA and no supplemental blocks like superficial cervical. You have to be comfortable with an ultrasound though, and moving the needle to at least two positions. To my knowledge, to date, there have been no reports of pneumothorax with this block under ultrasound guidance.
Why SCB over interscalene?? Cause you don't have to discuss hoarseness, Horner's syndrome or unilateral phrenic nerve palsy with patients. This is a TREMENDOUS advantage, and allows much greater acceptance if you are starting a regional program at your local hospital like I did. Furthermore, you are not exposing your patients to both regional and GA.
Ultrasound guided supraclavicular block is all you need for any type of upper extremity surgery including shoulder surgery. I routinely do even shoulder replacements with just this block and moderate sedation -yes, that means no GA and no supplemental blocks like superficial cervical. You have to be comfortable with an ultrasound though, and moving the needle to at least two positions. To my knowledge, to date, there have been no reports of pneumothorax with this block under ultrasound guidance.
Why SCB over interscalene?? Cause you don't have to discuss hoarseness, Horner's syndrome or unilateral phrenic nerve palsy with patients. This is a TREMENDOUS advantage, and allows much greater acceptance if you are starting a regional program at your local hospital like I did. Furthermore, you are not exposing your patients to both regional and GA.
Ultrasound guided supraclavicular block is all you need for any type of upper extremity surgery including shoulder surgery. I routinely do even shoulder replacements with just this block and moderate sedation -yes, that means no GA and no supplemental blocks like superficial cervical. You have to be comfortable with an ultrasound though, and moving the needle to at least two positions. To my knowledge, to date, there have been no reports of pneumothorax with this block under ultrasound guidance.
Why SCB over interscalene?? Cause you don't have to discuss hoarseness, Horner's syndrome or unilateral phrenic nerve palsy with patients. This is a TREMENDOUS advantage, and allows much greater acceptance if you are starting a regional program at your local hospital like I did. Furthermore, you are not exposing your patients to both regional and GA.
SO you believe that everyone that gets or would get a PTX after a block would report it?