Abstract
In the pediatric population, interscalene and supraclavicular blocks are not as commonly performed as blocks at the axillary level since the risks associated with a proximal technique deter many practitioners. These risks include pneumothorax, vertebral artery puncture and injection, epidural or intrathecal injection, phrenic nerve blockade resulting in hemidiaphragm paralysis, and recurrent laryngeal nerve blockade resulting in unilateral vocal cord paralysis. The use of ultrasound has the potential to reduce the risk of these events and may increase the use of interscalene and supraclavicular blocks in children due to ability to clearly visualize critical anatomical structures, including the pleural dome and subclavian and vertebral arteries. A combined nerve stimulation- and ultrasound-guided approach should be used where possible to localize the plexus at the level of the roots or trunks, thereby minimizing complications. Both approaches for interscalene brachial plexus block are described in this chapter.
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Suggested Reading
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Tsui, B.C.H. (2016). Interscalene Brachial Plexus Block. In: Tsui, B., Suresh, S. (eds) Pediatric Atlas of Ultrasound- and Nerve Stimulation-Guided Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-0-387-79964-3_19
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DOI: https://doi.org/10.1007/978-0-387-79964-3_19
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