# Iterscalene Plexus Nerve Blocks (PNB)

- Link: https://sifsof.com/clinical-apps/plexus-nerve-blocks-pnb/
- Published: 2019-11-23T08:55:29+00:00
- Author: Developer

The interscalene approach to brachial Plexus Nerve Blocks results in reliable anesthesia
of the shoulder and upper arm. The supraclavicular branches of the cervical plexus,
supplying the skin over the acromion and clavicle, are also blocked due to the proximal
and superficial spread of local anesthetic. The inferior trunk (C8-T1) is usually
spared unless the injection occurs at a more distal level of the brachial plexus.

 Ultrasound guidance allows for visualization of the spread of the local anesthetic
and additional injections around the brachial plexus if needed to ensure an adequate
spread of local anesthetic, improving block success. Consequently, reducing local
anesthetic volume required to accomplish the block.

### **Which ultrasound scanner for the interscalene plexus nerve block?**

An ultrasound machine with a linear transducer (10–14 MHz) [**SIFULTRAS-3.5**](https://sifsof.com/product/linear-handheld-wifi-ultrasound-scanner-10-12-14-mhz-sifultras-3-5/),
is needed for this procedure. The brachial plexus is typically visualized at a depth
of 1–3 cm. 

 Scanning usually begins just below the level of the [cricoid cartilage](https://en.wikipedia.org/wiki/Cricoid_cartilage)
and medial to the sternocleidomastoid muscle with the goal of identifying the carotid
artery. Once the artery has been identified, the transducer is moved slightly laterally
across the neck.

The goal is to identify the anterior and middle scalene muscles and the elements
of the brachial plexus that is located between them. It is recommended to use the**
color Doppler **to identify vascular structures and avoid them. The needle is then
inserted in-plane toward the brachial plexus, typically in a lateral-to-medial direction

The brachial plexus at the interscalene level is seen lateral to the carotid artery
and internal jugular vein, between the anterior and middle scalene muscles. Further,
An ultrasound-guided technique can also decrease the incidence of hemidiaphragmetic
paresis.  

This PNB clinical application may be performed by an **[Anesthesiologist](https://sifsof.com/product-category/doctor-specialties/anesthesiologist/)**.

![](https://sifsof.com/wp-content/uploads/2020/01/intersclane-nerve-block.jpg)

 * ![Mini Linear Handheld WiFi Ultrasound Scanner 10-12-14 MHz, SIFULTRAS-3.5 main](
   https://sifsof.com/wp-content/uploads/2019/03/SIFULTRAS-3.5-mini-linear-ultrasound-
   scanner-300x300.jpg)
 * Mini Linear Handheld WiFi Ultrasound Scanner 10-12-14 MHz, SIFULTRAS-3.5
 * ![Color Doppler Mini Linear WiFi Ultrasound Scanner SIFULTRAS-3.51 main](https://
   sifsof.com/wp-content/uploads/2018/11/SIFULTRAS-3.51-wireless-mini-linear-color-
   doppler-ultrasound-scanner-300x300.jpg)
 * Color Doppler Mini Linear WiFi Ultrasound Scanner SIFULTRAS-3.51

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_Although the information we provide is used but doctors, radiologists, medical 
staff to perform their procedures, clinical applications, the Information contained
in this article is for consideration only. We can’t be responsible for misuse of
the device nor for the device suitability with each clinical application or procedure
mentioned in this article.
Doctors, radiologists or medical staff must have the 
proper training and skills to perform the procedure with each ultrasound scanner
device.