I opted for this block during an a cubital tunnel release in situ / transposition (doc wasn't sure which he would do until he was in there)... I'm home now, from surgery about 8 hours ago. I am so glad i did it, so far. Sure, my whole arm feels really heavy and numb, and its a weird sensation to look at your hand and arm and have zero ability to move them, but i have absolutely zero pain right now, and that's allowed me to sleep comfortably after the surgery. I highly recommend this to anyone having surgery where its an option. But real-world side note... I'm typing this one handed which is a challenge, haha, but i do expect the block to wear off in the next 16 hours or so, I should regain control of the arm then and i have pain medication i can begin taking when that happens, but being able to go these first 24 hours with zero pain and the ability to sleep easily is a godsend!
I combine with supraclavicular (or could likely do with an infra/costoclavicular) if any distal humerus work - have found if intermedullary nail in distal humerus interscalene can miss this, for a very proximal and medial incision t1-3 innervation from intercostobrachial can be an issue. The subcut injection of local for the intercostobrachial nerve can help (or use ultrasound - I honestly cant normally see the nerve but it runs on top of the conjoint tendon above latissimus dorsi and so I tend to put some volume in this facial plane (from a slightly more posterior probe placement than a stardard "axillary" brachial plexus block) in the armpit.
Why in plane and not out of plane interscalene which doesn’t have a risk of damaging long thoracic and dorsal scapular also easier to insert a catheter ...
I went to get an interscalene block done the other day, but ended up being told I couldn't get it done due to my nerves being too inflamed and it would in turn make it worse 😞 My scalene muscles are fused to the c5, c6, c7 and part of the c8 nerve roots apparently. Very frustrating.
A surgeon has advised me to get an "interscalene block under ultra sound" for diagnostic purposes of pain in my right arm and upper back. The surgeon wants this block for diagnosing possible neurogenic thoracic outlet syndrome or some other nerve entrapment within my brachial plexus that causes my pain which travels along the dorsal scapular nerve, with burning along the scapular medial border & rhomboids as well as burning on my posterior arm/triceps and then numbness in 4th and 5th fingers. He is considering a scalenectomy of middle and anterior scalene if the block relieves there pain. Or some other peripheral nerve surgery. Can you tell me what type of nerve block would include the DSN? I'm concerned that a standard interscalene block will not block the DSN, therefore making this particular block somewhat missing the main suspected pain generator. Please advise what would include the DSN. Thank you
Can you let me know how you ended up going with your procedure and if you ended up having surgery? I am getting an interscalene block for NTOS coming up in the next couple weeks. Similar symptoms to you, my neck and ear burns when it's irritated, nerve pain down my arm, elbow and into all my fingers creating pins and needles. Originally was being treated for bursitis and impingement before it progressed into nerve pain. If the block doesn't work then I've been told I'd need "Scalene Lysis" surgery.
@@lisaeadesauthorandartist Hi Lisa. The block did help alleviate some of the pain. I decided to continue with injections w/steroid to control pain. It works well enough to keep me out of surgery and able to do my job. It wore off after 5 months and I got another injection. Still going ok with that one. If I can manage pain to tolerable level with these injections into the scalenes, I will put off surgery. Please let me know how your procedure works.
@@angelaclark5916 I'm so glad the block worked for you! I went to get my block done the other day, but unfortunately ended up being told my nerves are too inflamed to have it done. He proceeded to do an ultrasound and took some pictures of my scalene muscles that are fused to the c5, c6, c7 and partially to the c8 nerve roots. Was told if he gave the interscalene block it would essentially make my condition worse. If my nerves can settle down within the next couple of weeks then he will see if he can do a botox injection instead, before I see the orthopaedic surgeon. It's progressively getting worse for me unfortunately and I can't do my job at all until it gets sorted. Have been told it'll be months not weeks for a fix.
@@lisaeadesauthorandartist oh Lisa! I am so sorry. Hug to you. That is a very difficult situation you have. Can I message you some place? Are you on Facebook messenger?
@@lisaeadesauthorandartistdo you know what caused your initial inflammation? How are you doing a year later? Dealing with something similar but can’t get a diagnosis
I opted for this block during an a cubital tunnel release in situ / transposition (doc wasn't sure which he would do until he was in there)... I'm home now, from surgery about 8 hours ago. I am so glad i did it, so far. Sure, my whole arm feels really heavy and numb, and its a weird sensation to look at your hand and arm and have zero ability to move them, but i have absolutely zero pain right now, and that's allowed me to sleep comfortably after the surgery. I highly recommend this to anyone having surgery where its an option. But real-world side note... I'm typing this one handed which is a challenge, haha, but i do expect the block to wear off in the next 16 hours or so, I should regain control of the arm then and i have pain medication i can begin taking when that happens, but being able to go these first 24 hours with zero pain and the ability to sleep easily is a godsend!
Amazing video. I'm an incoming anesthesia trainee and will keep coming to these videos. Thanks
What black is used for teres major?
Is the sheath not an obstacle neither for the L. A to diffuse, in supraclavicular block too?
What are your thoughts on replacing the IBS block with the Superior Trunk Block?
Great video! For proximal humerus fracture, I often miss the incision with ISB block, which block can we add to cover the incision, sir?
I combine with supraclavicular (or could likely do with an infra/costoclavicular) if any distal humerus work - have found if intermedullary nail in distal humerus interscalene can miss this, for a very proximal and medial incision t1-3 innervation from intercostobrachial can be an issue. The subcut injection of local for the intercostobrachial nerve can help (or use ultrasound - I honestly cant normally see the nerve but it runs on top of the conjoint tendon above latissimus dorsi and so I tend to put some volume in this facial plane (from a slightly more posterior probe placement than a stardard "axillary" brachial plexus block) in the armpit.
Very well explained.
Why in plane and not out of plane interscalene which doesn’t have a risk of damaging long thoracic and dorsal scapular also easier to insert a catheter ...
Help me I am suffering for 20 years without solution.please
I went to get an interscalene block done the other day, but ended up being told I couldn't get it done due to my nerves being too inflamed and it would in turn make it worse 😞
My scalene muscles are fused to the c5, c6, c7 and part of the c8 nerve roots apparently.
Very frustrating.
A surgeon has advised me to get an "interscalene block under ultra sound" for diagnostic purposes of pain in my right arm and upper back.
The surgeon wants this block for diagnosing possible neurogenic thoracic outlet syndrome or some other nerve entrapment within my brachial plexus that causes my pain which travels along the dorsal scapular nerve, with burning along the scapular medial border & rhomboids as well as burning on my posterior arm/triceps and then numbness in 4th and 5th fingers.
He is considering a scalenectomy of middle and anterior scalene if the block relieves there pain. Or some other peripheral nerve surgery.
Can you tell me what type of nerve block would include the DSN? I'm concerned that a standard interscalene block will not block the DSN, therefore making this particular block somewhat missing the main suspected pain generator. Please advise what would include the DSN.
Thank you
Can you let me know how you ended up going with your procedure and if you ended up having surgery?
I am getting an interscalene block for NTOS coming up in the next couple weeks.
Similar symptoms to you, my neck and ear burns when it's irritated, nerve pain down my arm, elbow and into all my fingers creating pins and needles. Originally was being treated for bursitis and impingement before it progressed into nerve pain.
If the block doesn't work then I've been told I'd need "Scalene Lysis" surgery.
@@lisaeadesauthorandartist Hi Lisa. The block did help alleviate some of the pain. I decided to continue with injections w/steroid to control pain. It works well enough to keep me out of surgery and able to do my job. It wore off after 5 months and I got another injection. Still going ok with that one. If I can manage pain to tolerable level with these injections into the scalenes, I will put off surgery. Please let me know how your procedure works.
@@angelaclark5916 I'm so glad the block worked for you!
I went to get my block done the other day, but unfortunately ended up being told my nerves are too inflamed to have it done.
He proceeded to do an ultrasound and took some pictures of my scalene muscles that are fused to the c5, c6, c7 and partially to the c8 nerve roots.
Was told if he gave the interscalene block it would essentially make my condition worse.
If my nerves can settle down within the next couple of weeks then he will see if he can do a botox injection instead, before I see the orthopaedic surgeon.
It's progressively getting worse for me unfortunately and I can't do my job at all until it gets sorted. Have been told it'll be months not weeks for a fix.
@@lisaeadesauthorandartist oh Lisa! I am so sorry. Hug to you. That is a very difficult situation you have. Can I message you some place? Are you on Facebook messenger?
@@lisaeadesauthorandartistdo you know what caused your initial inflammation? How are you doing a year later? Dealing with something similar but can’t get a diagnosis
Thanks
nice video