Ultrasound-Guided CPNB for the Upper Extremity Part 1: Interscalene & Supraclavicular
US-Guided CPNB for the Upper Extremity Part 1: Interscalene and Supraclavicular from CPNB Consulting read more →
How do I assure that my Supraclavicular (& Other) CPNB catheters will be a success?
This post is an adaptation of a question that was emailed to me by Dr Sharanu Patil, an anesthesiologist at SPARSH Hospital in Bangalore, India. Dr Patil has has been using ‘ultrasound only’ techniques for seven years and has regular success utilizing ultrasound-guided single injection supraclavicular nerve blocks, however, he has found that inserting catheters.. read more →
Another Team Player
“Everybody here has a voice…and you should listen!” I make this point over and over when I help to implement a CPNB Program. I will go on to say that even if those putting the catheters in place are the best in the world, the outcome of the CPNB Program will still have more to.. read more →
Questions about Upper Extremity Blocks Answered
The following dialogue was generated through the CPNBconsulting.com website. This was initiated by a regional anesthesia enthusiast in Bangalore, India who had some questions for Dr Jones on upper extremity nerve blocks. Dear Sir, I had a few queries to clear from you: 1. Why after a supraclavicular block, are patients still be able.. read more →
Phrenic Nerve Dysfunction after ISB: my response to Recent Anesthesiology editorial
The following is my response as posted on PRACTICE OF REGIONAL ANESTHESIA on LinkedIn to: Phrenic Nerve Function After Interscalene Block Revisited: Now, the Long View by Hogan, Quinn H. M.D. Anesthesiology 119(2):250-252, August 2013 At first glance, this editorial and article were very concerning to me. As a profession, we do not have long-term.. read more →
INTERSCALENE
Converting from nerve stimulation to ultrasound for an interscalene nerve block classically involves going to a more posterior approach. This is also the case when changing from the traditional single injection to a continuous nerve block. For reasonable catheter securement issues as well as optimizing visualization with ultrasound, it becomes necessary to enter the skin several.. read more →
Total Shoulder, Bad Lungs
NOT MY USUAL STRATEGY I’ve mentioned elsewhere on this site that I have successfully taken care of many patients with this particular scenario, even those who are ‘oxygen-dependent’. The basic dilemma is whether to offer an interscalene block to someone that may have respiratory embarrassment due to spread to the phrenic nerve, knowing that without.. read more →
Block Evaluation
TAKE TIME TO LOOK BEFORE YOU LEAP Beyond visualizing a successful block on ultrasound, I usually will want to see an immediate effect of my local by asking the patient to raise their arm toward the ceiling (deltoids, C5 for an ISB) or extend their knee (for a femoral block). There are reasons why.. read more →