One important point not mentioned in the video - Ensure that the NERVES (the targets) are positioned in the centre of the screen. Observe from 1:35 onwards how the ARTERY is actually in the right third of the screen, rather than the centre, close to the needle entry site.. This reduces the distance the needle has to travel to reach the target nerves. This in turn avoids (1) trapping of the needle shaft in the soft tissues which will limit ability to maneuver the needle tip, and (2) pain from a long needle track through skin and muscle.
My attendings aren't fans of this block due to its theoric and practical difficulty. Thanks to your videos I've managed to succeed in a couple of last week procedures. Thank you kindly doc. I'm six months away from finishing the spec.
For sure, if it’s warranted. Most of our patients want to be asleep. so propofol infusion takes care or tourniquet discomfort. But I will do a ICBN infiltration (usually just landmark-guided subcut infiltration) for elbow surgery with a medial incision extending up the arm (e.g. ulnar nerve transposition / decompression). I tend to find that simpler than the described US-guided approach of injecting along the posterior conjoint tendon.
One important point not mentioned in the video - Ensure that the NERVES (the targets) are positioned in the centre of the screen. Observe from 1:35 onwards how the ARTERY is actually in the right third of the screen, rather than the centre, close to the needle entry site.. This reduces the distance the needle has to travel to reach the target nerves. This in turn avoids (1) trapping of the needle shaft in the soft tissues which will limit ability to maneuver the needle tip, and (2) pain from a long needle track through skin and muscle.
Thanks very much, teacher for his explanatory videos. Excellent technical and pedagogical quality
Excellently done!
My attendings aren't fans of this block due to its theoric and practical difficulty. Thanks to your videos I've managed to succeed in a couple of last week procedures.
Thank you kindly doc. I'm six months away from finishing the spec.
Thoughts on intercosterbrachial block at the same time?
For sure, if it’s warranted. Most of our patients want to be asleep. so propofol infusion takes care or tourniquet discomfort. But I will do a ICBN infiltration (usually just landmark-guided subcut infiltration) for elbow surgery with a medial incision extending up the arm (e.g. ulnar nerve transposition / decompression). I tend to find that simpler than the described US-guided approach of injecting along the posterior conjoint tendon.
@@KiJinnChin thanks!
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