Interscalene Bracial Plexus Block(US guided)

Date/Time:[]

Indications:[]

Provider: Self

Location: [Left/Right] Neck

A time out was completed, verifying correct patient, procedure, site, positioning, block type, and equipment

The patient’s lower neck was prepped with chlorhexidine and standard draping for procedure utilized. Using ultrasound, landmarks and appropriate injection site/path were identified. Skin and deeper tissues anesthetized with 2mL of  Bupivacane 0.5%. After appropriate US view obtained, the needle was advanced under real-time US guidance toward the target structures from posterior to anterior. Constant negative pressure was applied while advancing the needle. The needle was advanced through the middle scalene muscle into the nerve sheath between the C5 and C6 nerve roots. Low volume injection under low pressure was easily deposited, indicating proper placement into the nerve sheath. [10]mL of anesthetic was deposited with distinct blackening noted to extend superiorly and inferiorly along the nerve sheath. No signs or symptoms of intravascular uptake(LAST) or pain with injection reported or apparent. Signs and symptoms of successful nerve block, including increasing numbness of the clavicular region, shoulder, and upper arm were noted as well as weakening of the deltoid, indicating a successful block. Meaningful patient contact maintained throughout the procedure. The patient was counseled on the signs and symptoms of LAST.

Difficulty: None, minimal adjustments needed

Total anesthetic delivered: [10]ml

Time for Procedure: [20]minutes

Estimated blood loss: <1mL