The Parascalene Technique of Brachial Plexus Block for the Operation of the Upper Extremity and Shoulder. |
Kyeong Hee Kim, Keon Jung Yoon, Jun Goo Kang, Jong Lul Kim, Chung Hyuck Lim, Myung Woo Lee, Kyu Ho Park, Won Hee Han |
1Department of Anesthesiology, Daejeon St. Mary's Hospital, Catholic University, Taejeon, Korea. 2Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea. |
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Abstract |
BACKGROUND Brachial plexus is invested by a fascial envelope, which forms a perineural and perivascular space that extends all the way from the cervical intervertebral foramen to the distal axilla. Therefore a single injection of a local anesthetic into any sites of this space can provide anesthesia of the entire brachial plexus. Nowadays many methods of brachial plexus block have been developed but there are some severe complications and they can't prevent tourniquet pain completely. METHODS We have performed parascalene technique for brachial plexus block in 206 cases from Jan., 1992 to Dec.,1994. We studied the cases retrospectively by reviewing patients' anesthesia records. The technique for parascalene block is the injection of local anesthetic solution into the lower part of the posterior triangle of the neck at the point 1.5~2.0 cm above the clavicle at the lateral border of the anterior scalene muscle. RESULTS We could provide the proper anesthesia for the upper extremity and shoulder operation without any remarkable complications except Honor's syndrome of 3 cases.
And there were no tourniquet pain in all 96 cases who had used tourniquet. CONCLUSIONS The parascalene approach is the useful, safe and reliable method for brachial plexus block. |
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