Le point sur le bloc interscalénique

Interscalene block (ISB) of the brachial plexus provided effective analgesic to patients undergoing shoulder surgery, including a reduction in pain scores, opioid consumption, and postoperative nausea and vomiting. Continuous interscalene nerve block appeared to improve both short- and long-term outcomes following surgery. Recently, it was demonstrated that ultrasound approach reduced incidence of complications (accidental intravascular injection, failed bloc) and the effective dose of LA. Hemidiaphragmatic paresis is a constant challenge that may be reduced using lower volume and moving the injection site farther from the C3-5 roots. Anatomic consideration is the key to success.