Ultrasound-guided suprascapular nerve block, description of a novel supraclavicular approach.

Détails

ID Serval
serval:BIB_2E365AC89EDD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Ultrasound-guided suprascapular nerve block, description of a novel supraclavicular approach.
Périodique
Regional Anesthesia and Pain Medicine
Auteur(s)
Siegenthaler A., Moriggl B., Mlekusch S., Schliessbach J., Haug M., Curatolo M., Eichenberger U.
ISSN
1532-8651 (Electronic)
ISSN-L
1098-7339
Statut éditorial
Publié
Date de publication
2012
Volume
37
Numéro
3
Pages
325-328
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
BACKGROUND AND OBJECTIVES: The suprascapular nerve (SSN) block is frequently performed for different shoulder pain conditions and for perioperative and postoperative pain control after shoulder surgery. Blind and image-guided techniques have been described, all of which target the nerve within the supraspinous fossa or at the suprascapular notch. This classic target point is not always ideal when ultrasound (US) is used because it is located deep under the muscles, and hence the nerve is not always visible. Blocking the nerve in the supraclavicular region, where it passes underneath the omohyoid muscle, could be an attractive alternative.
METHODS: In the first step, 60 volunteers were scanned with US, both in the supraclavicular and the classic target area. The visibility of the SSN in both regions was compared. In the second step, 20 needles were placed into or immediately next to the SSN in the supraclavicular region of 10 cadavers. The accuracy of needle placement was determined by injection of dye and following dissection.
RESULTS: In the supraclavicular region of volunteers, the nerve was identified in 81% of examinations (95% confidence interval [CI], 74%-88%) and located at a median depth of 8 mm (interquartile range, 6-9 mm). Near the suprascapular notch (supraspinous fossa), the nerve was unambiguously identified in 36% of examinations (95% CI, 28%-44%) (P < 0.001) and located at a median depth of 35 mm (interquartile range, 31-38 mm; P < 0.001). In the cadaver investigation, the rate of correct needle placement of the supraclavicular approach was 95% (95% CI, 86%-100%).
CONCLUSIONS: Visualization of the SSN with US is better in the supraclavicular region as compared with the supraspinous fossa. The anatomic dissections confirmed that our novel supraclavicular SSN block technique is accurate.
Mots-clé
Adult, Aged, Aged, 80 and over, Cadaver, Chi-Square Distribution, Coloring Agents/administration & dosage, Female, Humans, Indocyanine Green/administration & dosage, Injections, Male, Middle Aged, Nerve Block/adverse effects, Nerve Block/methods, Patient Positioning, Peripheral Nerves/anatomy & histology, Peripheral Nerves/ultrasonography, Shoulder/innervation, Supine Position, Switzerland, Ultrasonography, Interventional, Young Adult
Pubmed
Web of science
Création de la notice
19/05/2012 18:43
Dernière modification de la notice
20/08/2019 13:12
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