Der interskalenäre Plexuskatheter zur Anästhesie und postoperativen Schmerztherapie

Meier, Gisela; Bauereis, C.; Heinrich, Cherrie A.

doi:10.1007/s001010050458

Cited by 81 publications

(26 citation statements)

References 8 publications

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“…Winnie [24] determined the same insertion site but advanced the needle medially and dorsally into the interscalene gap. Meier [12] described an insertion point more cephalad, also orienting on the interscalene gap. In the latter technique the advanced needle reached the superior trunk of the brachial plexus as well as the lateral convex curve of the phrenic nerve on its way to the ventral face of the anterior scalene muscle.…”

Section: Discussionmentioning

confidence: 99%

“…Common approaches for brachial plexus blockade, like the interscalene block [24] or its modification [3,12] are associated with a variety of side effects and complications, systematically listed by Long et al [11]. They are caused by spread of local anesthetics solution to structures medially to the lateral margin of the anterior scalene muscle and by advancement of the needle medially into vessels or lung.…”

Section: Discussionmentioning

confidence: 99%

“…Several different approaches can be found in the literature: the interscalene block described by Winnie [24], its modification by Meier and Bauereis [12], Borgeat [3] and the supraclavicular approaches by Kulenkampff [9], Pham-Dang [15] and Moorthy [14]. Winnie's interscalene approach uses an insertion site at the level of the cricoid cartilage, from which the needle is advanced in a medial, dorsal and caudal direction perpendicular to the skin (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…A safer approach would involve directing the needle insertion and anesthetic spread in a lateral direction. Meier has used this [12] by determining a very high insertion point 3 cm cranial to the cricoid cartilage ( Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

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A supraomohyoidal plexus block designed to avoid complications

et al. 2006

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Interscalene blocks of the brachial plexus are used for surgery of the shoulder and are frequently associated with complications such as temporary phrenic block, Horner syndrome or hematoma. To minimize the risk of these complications, we developed an approach that avoids medially directed needle advancement and favors spread to lateral regions only: the supraomohyoidal block. We tested this procedure in 11 cadavers fixed by Thiel's method. The insertion site is at the lateral margin of the sternocleidomastoid muscle at the level of the cricoid cartilage. The needle is inserted in the axis of the plexus with an angle of approximately 35°t o the skin, and advanced in lateral and caudal direction. Distribution of solution was determined in ten cadavers after bilateral injection of colored solution (20 and 30 ml) and followed by dissection. In an eleventh cadaver, computerized tomography and 3D reconstruction after radio contrast injection was performed. In additional five cadavers we performed Winnie's technique with bilateral injection (20 and 30 ml).Concerning the supraomohyoidal block the injection mass reached the infraclavicular region surrounded all trunks of the brachial plexus in the supraclavicular region and the suprascapular nerve in all cases. The solution did not spread medially beyond the lateral margin of the anterior scalene muscle into the scalenovertebral triangle.Therefore, phrenic nerve, stellate ganglion, laryngeal nerve nor the vertebral artery were exposed to the injected solution. Distribution was comparable with the use of 20 and 30 ml of solution. Injections on five cadavers performing the interscalene block of Winnie resulted in an extended spread medially to the anterior scalene muscle.We conclude that our method may be a preferred approach due to its safety, because no structures out of interest were reached. Solution of 20 ml is suggested to be enough for a successful block.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A supraomohyoidal plexus block designed to avoid complications

et al. 2006

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“…Worthy of mention are the Meier and Borgeat [12,13] modifications. Recent work using magnetic resonance and computerised tomography imaging in healthy volunteers and cadavers suggests that the traditional Winnie approach can align the needle trajectory with the intervertebral foramen, thus allowing the needle access to the neuraxis [14,15].…”

Section: Blocks Above the Claviclementioning

confidence: 99%

Upper limb blocks

2010

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Summary This article discusses recent innovations and changes in practice in upper limb regional anaesthesia, dividing the blocks into those performed above the clavicle, those performed in the area of the clavicle and those performed below it. It offers a critical appraisal of the current status with regard to the use of ultrasound nerve location for upper limb regional anaesthesia and, while accepting that the use of ultrasound in this way has many theoretical advantages and will therefore continue to grow, concludes that there is currently insufficient published evidence to determine conclusively that the use of this technique is associated with nerve blocks that are more successful or safer.

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References

2004

Regional Nerve Blocks and Infiltration Therapy

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Der interskalenäre Plexuskatheter zur Anästhesie und postoperativen Schmerztherapie

Abstract: We consider the modified ISB with catheter a safe and effective procedure for anaesthesia and postoperative pain management of open and closed shoulder surgery.

Cited by 81 publications

References 8 publications

A supraomohyoidal plexus block designed to avoid complications

A supraomohyoidal plexus block designed to avoid complications

Upper limb blocks

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