https://wikem.org/w/api.php?action=feedcontributions&feedformat=atom&user=Stephenbrown 2026-05-13T23:03:10Z User contributions MediaWiki 1.38.2 https://wikem.org/w/index.php?title=User:Stephenbrown&diff=106574 2016-10-17T15:11:36Z

<p>Stephenbrown: my profile</p> <hr /> <div>Stephen Brown, MD in 2018 applying into EM.<br /> UCSF</div>

Stephenbrown https://wikem.org/w/index.php?title=Nerve_block:_intrascalene&diff=106567 2016-10-17T14:31:42Z

<p>Stephenbrown: expanded previous material, provided link with much more in depth instruction/videos/photos</p> <hr /> <div>==Overview==<br /> An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.&lt;ref&gt;Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080&lt;/ref&gt; <br /> ==Indications==<br /> *Post operative analgesia for shoulder surgery<br /> *[[Humerus fracture]]<br /> * Lacerations or abscesses of upper arm and deltoid<br /> <br /> ==Contraindications==<br /> *Severe lung disease<br /> **Due to risk of unilateral pneumothorax<br /> *Overlying infection<br /> *Allergy to anesthetics<br /> *Phrenic nerve dysfunction<br /> **Specifically contralateral phrenic nerve dysfunction, due to the risk of unilateral paralysis<br /> ==Equipment Needed==<br /> * Linear Probe<br /> * 25 g needle<br /> * 5-10cc local anesthetic<br /> <br /> ==Procedure==<br /> * Always check for the transverse cervical artery using color Doppler. <br /> * Keep needle tip as far from the nerve roots as possible. <br /> * Assume phrenic paralysis and avoid in patients with tenuous respiratory status.<br /> <br /> ==Complications==<br /> *Phrenic nerve dysfunction&lt;ref&gt;Borgeat A et al. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct. 95(4):875-80&lt;/ref&gt; <br /> **Causing unilateral diaphragmatic paralysis and respiratory distress.<br /> *[[Pneumothorax]]&lt;ref&gt;Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.&lt;/ref&gt;<br /> **On the side of the nerve block<br /> ==See Also==<br /> *[[Nerve Blocks]]<br /> ==External Links==<br /> Great instructional page from Highland on the intrascalene nerve block<br /> http://highlandultrasound.com/interscalene-block/<br /> <br /> ==References==<br /> &lt;references/&gt;<br /> <br /> [[Category:Procedures]][[Category:Ultrasound]]</div>

Stephenbrown https://wikem.org/w/index.php?title=Nerve_block:_intrascalene&diff=106566 2016-10-17T14:29:03Z

<p>Stephenbrown: /* Procedure */</p> <hr /> <div>==Overview==<br /> An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.&lt;ref&gt;Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080&lt;/ref&gt; <br /> ==Indications==<br /> *Post operative analgesia for shoulder surgery<br /> *[[Humerus fracture]]<br /> * Lacerations or abscesses of upper arm and deltoid<br /> <br /> ==Contraindications==<br /> *Severe lung disease<br /> **Due to risk of unilateral pneumothorax<br /> *Overlying infection<br /> *Allergy to anesthetics<br /> *Phrenic nerve dysfunction<br /> **Specifically contralateral phrenic nerve dysfunction, due to the risk of unilateral paralysis<br /> ==Equipment Needed==<br /> * Linear Probe<br /> * 25 g needle<br /> * 5-10cc local anesthetic<br /> <br /> ==Procedure==<br /> * Always check for the transverse cervical artery using color Doppler. <br /> * Keep needle tip as far from the nerve roots as possible. <br /> * Assume phrenic paralysis and avoid in patients with tenuous respiratory status.<br /> <br /> ==Complications==<br /> *Phrenic nerve dysfunction&lt;ref&gt;Borgeat A et al. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct. 95(4):875-80&lt;/ref&gt; <br /> **Causing unilateral diaphragmatic paralysis and respiratory distress.<br /> *[[Pneumothorax]]&lt;ref&gt;Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.&lt;/ref&gt;<br /> **On the side of the nerve block<br /> ==See Also==<br /> *[[Nerve Blocks]]<br /> ==External Links==<br /> <br /> ==References==<br /> &lt;references/&gt;<br /> <br /> [[Category:Procedures]][[Category:Ultrasound]]</div>

Stephenbrown https://wikem.org/w/index.php?title=Nerve_block:_intrascalene&diff=106565 2016-10-17T14:27:20Z

<p>Stephenbrown: /* Equipment Needed */</p> <hr /> <div>==Overview==<br /> An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.&lt;ref&gt;Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080&lt;/ref&gt; <br /> ==Indications==<br /> *Post operative analgesia for shoulder surgery<br /> *[[Humerus fracture]]<br /> * Lacerations or abscesses of upper arm and deltoid<br /> <br /> ==Contraindications==<br /> *Severe lung disease<br /> **Due to risk of unilateral pneumothorax<br /> *Overlying infection<br /> *Allergy to anesthetics<br /> *Phrenic nerve dysfunction<br /> **Specifically contralateral phrenic nerve dysfunction, due to the risk of unilateral paralysis<br /> ==Equipment Needed==<br /> * Linear Probe<br /> * 25 g needle<br /> * 5-10cc local anesthetic<br /> <br /> ==Procedure==<br /> <br /> ==Complications==<br /> *Phrenic nerve dysfunction&lt;ref&gt;Borgeat A et al. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct. 95(4):875-80&lt;/ref&gt; <br /> **Causing unilateral diaphragmatic paralysis and respiratory distress.<br /> *[[Pneumothorax]]&lt;ref&gt;Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.&lt;/ref&gt;<br /> **On the side of the nerve block<br /> ==See Also==<br /> *[[Nerve Blocks]]<br /> ==External Links==<br /> <br /> ==References==<br /> &lt;references/&gt;<br /> <br /> [[Category:Procedures]][[Category:Ultrasound]]</div>

Stephenbrown https://wikem.org/w/index.php?title=Nerve_block:_intrascalene&diff=106562 2016-10-17T14:24:47Z

<p>Stephenbrown: /* Indications */</p> <hr /> <div>==Overview==<br /> An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.&lt;ref&gt;Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080&lt;/ref&gt; <br /> ==Indications==<br /> *Post operative analgesia for shoulder surgery<br /> *[[Humerus fracture]]<br /> * Lacerations or abscesses of upper arm and deltoid<br /> <br /> ==Contraindications==<br /> *Severe lung disease<br /> **Due to risk of unilateral pneumothorax<br /> *Overlying infection<br /> *Allergy to anesthetics<br /> *Phrenic nerve dysfunction<br /> **Specifically contralateral phrenic nerve dysfunction, due to the risk of unilateral paralysis<br /> ==Equipment Needed==<br /> <br /> ==Procedure==<br /> <br /> ==Complications==<br /> *Phrenic nerve dysfunction&lt;ref&gt;Borgeat A et al. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct. 95(4):875-80&lt;/ref&gt; <br /> **Causing unilateral diaphragmatic paralysis and respiratory distress.<br /> *[[Pneumothorax]]&lt;ref&gt;Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.&lt;/ref&gt;<br /> **On the side of the nerve block<br /> ==See Also==<br /> *[[Nerve Blocks]]<br /> ==External Links==<br /> <br /> ==References==<br /> &lt;references/&gt;<br /> <br /> [[Category:Procedures]][[Category:Ultrasound]]</div>

Stephenbrown https://wikem.org/w/index.php?title=Nerve_block:_intrascalene&diff=106561 2016-10-17T14:22:33Z

<p>Stephenbrown: /* Indications */</p> <hr /> <div>==Overview==<br /> An interscalene nerve block is a regional anesthesia technique, usually performed under ultrasound guidance to provide anesthesia to the shoulder and the upper arm.&lt;ref&gt;Ullah H. et al. Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery. Cochrane Database Syst Rev. 2014 CD007080&lt;/ref&gt; <br /> ==Indications==<br /> *Post operative analgesia for shoulder surgery<br /> *[[Humerus fracture]]<br /> * Drainage of deltoid abscess<br /> <br /> ==Contraindications==<br /> *Severe lung disease<br /> **Due to risk of unilateral pneumothorax<br /> *Overlying infection<br /> *Allergy to anesthetics<br /> *Phrenic nerve dysfunction<br /> **Specifically contralateral phrenic nerve dysfunction, due to the risk of unilateral paralysis<br /> ==Equipment Needed==<br /> <br /> ==Procedure==<br /> <br /> ==Complications==<br /> *Phrenic nerve dysfunction&lt;ref&gt;Borgeat A et al. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct. 95(4):875-80&lt;/ref&gt; <br /> **Causing unilateral diaphragmatic paralysis and respiratory distress.<br /> *[[Pneumothorax]]&lt;ref&gt;Auroy Y. et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002 Nov. 97(5):1274-80.&lt;/ref&gt;<br /> **On the side of the nerve block<br /> ==See Also==<br /> *[[Nerve Blocks]]<br /> ==External Links==<br /> <br /> ==References==<br /> &lt;references/&gt;<br /> <br /> [[Category:Procedures]][[Category:Ultrasound]]</div>

Stephenbrown