couldn‘t agree more. still much disbelief in colleagues saying that medial clavicular Fx cannot be blocked! central lines work like a charm! great video! would love to see your approach to parasacral sciatic and psoas compartment block! we could also collaborate if desired!
Great video as ever!! I note in your blocks for clavicle # you mentioned phrenic block with this as less common than with isb. But the local in this video appears to go right over the anterior scalene towards the phrenic? Do you find frequent phrenic block with this? Awake central lines in my institution are frequent with covid crit care admissions on high flow nasal cannula but phrenic palsy may condemn them to invasive ventilation?
Excellent video. Very informative. I have a comment that at 6.20 minutes it is mentioned that local anesthetic is injected between SCM and Scalene Anterior muscle (probably you meant Middle Scalene muscle). Injection of Local Anesthetic over scalene Anterior muscle will block phrenic nerve (which should be avoided).
Thought the same. You can actually see the phrenic nerve in the video and the local very close to it. For me it’s usually the supraclav. Nerve I want blocked so I find it, track it a little more distally an inject the lokal just around that nerve. In that way I’m a little further from the phrenic nerve.
Thanks for sharing this one. Since you don't go into detail about the procedures this is suitable for - is the SCB generally sufficient for carotid surgery? I do realize there are variations due to tissue growth during embryonic development and some local supplementation has to be given by the surgeons during procedure ...
@@regionalanesthesiology it concern me as well since we know that phrenic nerve lies on anterior scalene muscle ...and the video shows LA spread to surface of anterior scalene muscle even with 5-8 mls of LA
You have made the best video I've found on this block. Good job.
Incredible didactics! Lean, precise, relevant. Amazing job.
couldn‘t agree more. still much disbelief in colleagues saying that medial clavicular Fx cannot be blocked! central lines work like a charm! great video! would love to see your approach to parasacral sciatic and psoas compartment block! we could also collaborate if desired!
A Home Run as usual! Keep them coming…
Great video as ever!! I note in your blocks for clavicle # you mentioned phrenic block with this as less common than with isb. But the local in this video appears to go right over the anterior scalene towards the phrenic? Do you find frequent phrenic block with this? Awake central lines in my institution are frequent with covid crit care admissions on high flow nasal cannula but phrenic palsy may condemn them to invasive ventilation?
Excellent video. Very informative. I have a comment that at 6.20 minutes it is mentioned that local anesthetic is injected between SCM and Scalene Anterior muscle (probably you meant Middle Scalene muscle). Injection of Local Anesthetic over scalene Anterior muscle will block phrenic nerve (which should be avoided).
Thought the same. You can actually see the phrenic nerve in the video and the local very close to it. For me it’s usually the supraclav. Nerve I want blocked so I find it, track it a little more distally an inject the lokal just around that nerve. In that way I’m a little further from the phrenic nerve.
Thankyou, very good explanation.
Great video 👍
Excellent
Excellent explanation and demonestration
Thank you for watching!
Wouldn't this be a tad excessive for a central venous line insertion? We generally do it only under local anaesthetic.
Thanks for sharing this one.
Since you don't go into detail about the procedures this is suitable for - is the SCB generally sufficient for carotid surgery?
I do realize there are variations due to tissue growth during embryonic development and some local supplementation has to be given by the surgeons during procedure ...
Sure is I’m just refreshing but this is what I’ll be using tomorrow for CEA
Can this block be used for submandibular gland surgery?
Is superficial or deep c B .. helpful in abolishing vasospasm that can occur after intracranial Aneurysm clipping
Question: I assume if this block is done for a thyroid/parathyroid procedure for post-op analgesia, it would be a Bilateral SCP Block?
You should consider, that there is a risk of bilateral phrenic nerve block, with bilateral SCP block.
How does clavipectoral + CPB compare to interscalene + CPB for # clavicle surgery?
In my experience, clavipectoral and CPB work great. Still able to MAC the case
@@dutchg00 i have same experience. love it!
03:30
Almost fell out my chair laughing😅
Will the phrenic nerve be infiltrated by this technique? thanks
@@regionalanesthesiology it concern me as well since we know that phrenic nerve lies on anterior scalene muscle ...and the video shows LA spread to surface of anterior scalene muscle even with 5-8 mls of LA
Yes. It also my concern.
❤
Overkill for a central line. Just use sq local anesthetic injection.