Interscalene nerve block

Patient 30 degrees head-up

At edge of bed. Pillow pushed.

Neck rotated slightly away.

Can stand north or south.

SCAN

From supraclavicular region.

Identify subclavian artery pulsating. Identify brachial plexus nerves superior/lateral/posterior.

SCAN cephalad to identify roots (C5,6,7) between anterior and medial scalene

Approach from posteriorly. 50mm simplex needle

20ml of 0.375% for analgesia, 0.5% + lignocaine for anaesthesia

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