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Posterior Interscalene Block

Title
That which we call a rose by any other name would smell as sweet – and its thorns would hurt as much
Author
Boezaart AP
Journal
Regional Anesthesia and Pain Medicine 2009 Jan-Feb; 34(1): 3-7.

 

Study Summary

 

Study design
  • Editorial

 

Comments on the study

  • This is an extremely informative editorial that should be read in conjunction with the case reports by Mariano1 and Antonakakis2 in the same journal on the posterior interscalene block.
  • Dr Borgeat highlights the similarity of this US-guided posterior interscalene block to the cervical paravertebral block3. He also puts forward the tantalizing prospect that targeting the posterior aspect of the nerve root may be able to result in preferential blockade of pain / sensation versus motor function.
  • The second half of his article provides an informative discussion of the anatomical and functional difference between root, plexus and peripheral nerve and the implications for regional anesthesia. It is recommended reading for all regional practitioners seeking to refine or improve their technique.

References

  1. Mariano ER, Loland VJ, Ilfeld BM. Interscalene perineural catheter placement using an ultrasound-guided posterior approach. Reg Anesth Pain Med 2009;34:60-63.
  2. Antonakakis JG, Sites BD, Shiffrin J. Ultrasound-guided posterior approach for the placement of a continuous interscalene catheter. Reg Anesth Pain Med 2009;34:64-68.
  3. Boezaart AP, Koorn R, Rosenquist RW. Paravertebral approach to the brachial plexus: an anatomic improvement in technique. Reg Anesth Pain Med 2003;28:241-244.