- Marmara Medical Journal
- Vol: 33 Issue: 3
- Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clini...
Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications
Authors : Alper Kilicaslan, Funda Gok, Ismail Hakkı Korucu, Asiye Ozkan, Resul Yilmaz
Pages : 141-145
Doi:10.5472/marumj.816311
View : 10 | Download : 5
Publication Date : 2020-10-23
Article Type : Research
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.Keywords : Brachial plexus, Interscalene block, Ultrasonography, Variations