SavedAdd your journal

Journals / Marmara Medical Journal / 2020 / Cilt: 33 - Sayı: 3

Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications

Alper KİLİCASLAN
Funda GOK
Ismail Hakkı KORUCU
Asiye OZKAN
RESUL YILMAZ
Pages
141–145
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We consider that prospective studies including more populations are needed to elucidate the effects of these variations on block parameters.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Our aim was to evaluate the anatomic variations detected during ultrasound-guided interscalene brachial plexus block (US-ISB) and present their clinical implications.
📊
Key Findings & Data:Results: Anatomical variations which were considered to affect the block technique were detected in 13 (11.8%) of 110 patients.
💡
Conclusion & Impact:We consider that prospective studies including more populations are needed to elucidate the effects of these variations on block parameters.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Brachial plexus · Interscalene block · Ultrasonography

Abstract

Objective: Our aim was to evaluate the anatomic variations detected during ultrasound-guided interscalene brachial plexus block (US-ISB) and present their clinical implications. Materials and Methods: After the ethical approval for the study was obtained from the local ethics committee, the files and US records of patients who underwent US-ISB for anesthesia of the shoulder surgery were retrospectively analyzed. Results: Anatomical variations which were considered to affect the block technique were detected in 13 (11.8%) of 110 patients. C5 cervical root pierced the anterior scalene muscle (ASM) in 4.5%, and ventral rami of C5 and/or C6 were located in ASM in 3.6% of patients. There was a muscle bridge between C5 to C6 and C5 to C7 roots in 1.8% of the patients. The brachial plexus was located medial to ASM and missing from interscalene groove in 1.8% of patients. In one case (C5 root was located in ASM), US-ISB resulted in incomplete brachial plexus anesthesia, and so general anesthesia (GA) was performed. Conclusion: Some of the brachial plexus variations in the interscalene area may be associated with further needle manipulation/ redirection and block failure. We consider that prospective studies including more populations are needed to elucidate the effects of these variations on block parameters.

🔖

Cite This Article

KİLİCASLAN, A., GOK, F., KORUCU, I. H., OZKAN, A., YILMAZ, R. (2020). Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Medical Journal, Cilt: 33 - Sayı: 3, 141–145. https://ajindex.com/articles/283801

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (2)

  1. Harry WG, Bennett JD, Guha SC. Scalene muscles and the brachial plexus: anatomical variations and their clinical significance. Clin Anat 1997;10:250-2. doi:10.1002/ (SICI)1098-2353(1997)10:4 Cash CJ, Sardesai AM, Berman LH, et al. Spatial mapping of the brachial plexus using three-dimensional ultrasound. Br J Radiol 2005;78(936):1086-94. doi:10.1259/bjr/36348588 Chin KJ, Niazi A, Chan V. Anomalous brachial plexus anatomy in the supraclavicular region detected by ultrasound. Anesth Analg 2008;107:729-31. doi: 10.1213/ane.0b013e31817dc887 Gutton C, Choquet O, Antonini F, Grossi P. Ultrasoundguided interscalene block: influence of anatomic variations in clinical practice (French). Ann Fr Anesth Reanim 2010; 29: 770-5. doi: 10.1016/j.annfar.2010.07.013 Kapral S, Greher M, Huber G, Willschke H, Kettner S, Kdolsky R, et al. Ultrasonographic guidance improves the success rate of interscalene brachial plexus blockade. Reg Anesth Pain Med 2008;33:253–8. doi: 10.1016/j.rapm.2007.10.011 Kessler J, Gray AT. Sonography of scalene muscle anomalies for brachial plexus block. Reg Anesth Pain Med 2007;32:172- 3. doi: 10.1016/j.rapm.2006.09.011 Feigl GC, Pixner T. Combination of variations of the interscalene gap as a pitfall for ultrasound-guided brachial plexus block. Reg Anesth Pain Med 2011;36:523–4. doi: 10.1097/AAP.0b013e31822897f1 Abrahams MS, Panzer O, Atchabahian A, et al. Case Report: Limitation of Local Anesthetic Spread During Ultrasound- Guided Interscalene Block. Description of an Anatomic Variant With Clinical Correlation. Reg Anesth Pain Med 2008;33:357-9. doi:10.1016/j.rapm.2008.01.015 Feigl GC, Litz RJ, Marhofer P. Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy. Reg Anesth Pain Med.2020;45:620-7. doi: 10.1136/rapm-2020-101435
  2. Feigl GC, Pixner T. The cleidoatlanticus muscle: a potential pitfall for the practice of ultrasound guided interscalene brachial plexus block. Surg Radiol Anat 2011; 33: 823–5. doi: 10.1007/s00276.011.0820-z Kilicaslan A, Gürkan Y, Tekin M. A brachial plexus variation identified during ultrasound-guided interscalene block. Agri 2012; 24: 194. doi: 10.5505/agri.2012.34966 Koscielniak-Nielsen ZJ. Ultrasound-guided peripheral nerve blocks: what are the benefits? Acta Anaesthesiol Scand 2008;52:727-37. doi: 10.1111/j.1399-6576.2008.01666.x Leonhard V, Smith, R, Caldwell, G, Smith, HF. Anatomical variations in the brachial plexus roots: implications for diagnosis of