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Better suprascapular coverage (posterior shoulder) than supraclavicular block. Suprascapular nerve may branch off plexus before the site of the block

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Jun 03, 2011
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Provides reliable anesthesia for surgery on the shoulder, upper arm, and elbow. Not suitable for hand surgery as the medial aspect of the distal arm is not reliably covered by the interscalene block. refl.in/kk

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Jan 24, 2014
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Phrenic nerve palsy on side of block is almost guaranteed, so consider consequences of unilateral diaphragmatic paralysis on patient's pulmonary reserve prior to proceeding

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Aug 07, 2011
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Severe COAD/CAL/emphysema is a relative contraindication. Phrenic nerve palsy is almost guaranteed, and may result in post operative respiratory failure #ref

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May 18, 2011
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This case report of a patient death demonstrates the risk of intrathecal catheter migration and development of a total spinal in patients with interscalene catheters.

dx.doi.org/10.1111/j.1365...

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Jan 24, 2013
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Consider using a sharp cutting spinal needle (eg 22g quincke).
This is adequately echogenic but slides through the tissue planes without causing anatomical distortion.

#WCA2016

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Aug 30, 2016
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Accessory nerve (XI) runs posterior to the brachial plexus over the middle & posterior scalene muscle. Contraction of the trapezius indicates placement of the needle posterior to the plexus refl.in/92

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Aug 06, 2011
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Expected distribution of block refl.in/2g #ref

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Aug 26, 2013
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Intercostobrachial nerve won't be blocked, so upper medial aspect of arm will have sensation which may be problematic if limb torniquet is used

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Jul 10, 2011
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Allow up to 30 min for block to work.

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Jul 28, 2011
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Nerve stimulator technique: Nysora refl.in/92

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Jul 10, 2011
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