Suprascapular Nerve Block with fluoro

[Mofeen]

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Anyone have any tips for utilizing flouro to obtain good images of the suprascapular notch for a safe approach for this block. Did about 10 in fellowship (1 year out) with pretty good results and I have one tomorrow. I just remember taking a long time playing with the flouro to get a good image almost every time. Thanks.

 

[Ducttape]

I use ultrasound for them... Sorry...

 

[Tenesma]

i use fluoro... it does take some playing around w/ c-arm..

 

[PMR2008]

This is the technique we are using in my fellowshiphttp://www.painphysicianjournal.com/2007/november/2007;10;743-746.pdf

 

[giddyup]

Position with arm lying at their side. I go about 35 to 40 degrees tilt to get the spine of the scapula out of the way, then from lateral to medial I look for the GH joint, the coracoid, then the notch should be just medial to the coracoid. Sometimes hard to see but then I just do the best I can using the spine and the coracoid as landmarks - land on os and deposit injectate. Hope this helps.

 

[DOctorJay]

This is the technique we are using in my fellowshiphttp://www.painphysicianjournal.com/2007/november/2007;10;743-746.pdf

Do you guys use extension tubing like in the picture as well? I've often thought this would make needle driving easier and less likely to move the tip away from he target during injection. I haven't tried it yet with US though.

 

[Ducttape]

this is clearly a case where US is much easier than fluoro.

i read that article in Pain Physician. its pretty good, but sometimes visual instruction is better.

if you can stand the instructor's accent, this video explains it very well and easily...
http://www.youtube.com/watch?v=dgAedXjhxHw

this one is also pretty good.
http://www.youtube.com/watch?v=S8yP_9wuG2Q

 

[ghost dog]

Anyone have any tips for utilizing flouro to obtain good images of the suprascapular notch for a safe approach for this block. Did about 10 in fellowship (1 year out) with pretty good results and I have one tomorrow. I just remember taking a long time playing with the flouro to get a good image almost every time. Thanks.

Thoughts on blind technique ?

 

[bedrock]

Thoughts on blind technique ?

sucks,

US better than fluoro, fluoro at least reasonable.
Blind technique less than SOC in modern medicine

 

[PMR2008]

Do you guys use extension tubing like in the picture as well? I've often thought this would make needle driving easier and less likely to move the tip away from he target during injection. I haven't tried it yet with US though.

We are using extension tubing for almost all nerve blocks. I do believe that it makes things easier. For joints we do not use extension tubing.