Refining the ultrasound-guided interscalene brachial plexus block: the superior trunk approach

摘要

The conventional ultrasound-guided interscalene block targets the C5 and C6 nerve roots at approximately the level of the cricoid cartilage where they lie in the groove between the anterior and middle scalene muscles. This technique, although effective at providing regional anesthesia of the shoulder, is associated with risks of phrenic nerve palsy, injury to the dorsal scapular and long thoracic nerves, and long-term postoperative neurologic symptoms. In this case report, we describe the ultrasound-guided superior trunk block. This procedure targets the C5 and C6 components of the brachial plexus more distally after they unite into the superior trunk but before the suprascapular nerve branches off.