EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award WFUMB 2011 VIENNA AUSTRIA 28 August 2011 13.50 – 15.45 10 minutes each for presentation plus 3 minutes discussion An Ultrasound Study of the Phrenic Nerve in the Posterior Cervical Triangle: Implications for the Interscalene Brachial Plexus Block
Jens Kessler University Hospital Heidelberg
ABSTRACT The interscalene block of the brachial plexus is one of the most important regional anaesthesia techniques in the world. In the first description of this invasive procedure it was recommended to choose the cricoid cartilage as the reference point for insertion of the needle. More than 40 years later avoidance of the interscalene plexus block is suggested in patients with chronic respiratory disease, chronic obstructive lung disease, bronchial asthma, and advanced pregnancy, or in patients with a high body mass index because of phrenic paralysis resulting from this kind of nerve block. The aim of the study was ultrasonographic description of the shape, size, and course of the phrenic nerve along the neck, and its relationship to the brachial plexus, to educate regional anaesthesiologists about the ultrasonic appearance of the phrenic nerve during interscalene or supraclavicular block. In this prospective observational study, 23 volunteers underwent phrenic nerve examination on both sides of the neck by use of a linear 14-MHz ultrasound probe. The phrenic nerve could be identified in 93.5% of all scans.