Articles: nerve-block.
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The failure rate and complications following thoracic and lumbar paravertebral blocks performed in 620 adults and 42 children were recorded. The technique failure rate in adults was 6.1%. No failures occurred in children. ⋯ No complications were noted in the children. The use of a bilateral paravertebral technique was found approximately to double the likelihood of inadvertent vascular puncture (9% vs. 5%) and to cause an eight-fold increase in pleural puncture and pneumothorax (3% vs. 0.4%), when compared with unilateral blocks. The incidence of other complications was similar between bilateral and unilateral blocks.
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Anesthesia and analgesia · Dec 2001
Case ReportsThe use of a "reverse" axis (axillary-interscalene) block in a patient presenting with fractures of the left shoulder and elbow.
A patient presented for surgery to repair a fractured left shoulder and elbow and requested regional anesthesia. Most upper extremity operations require a single brachial plexus nerve block. The position of the two fractures however required the use of two separate approaches, an interscalene and an axillary approach.
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This is a relatively specialised technique aimed more at enhancing the skills of doctors regularly performing local anaesthetic blocks. It is a useful device for confirming the location of major nerves and plexuses proximally, but not necessary for most peripheral nerve blocks.