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Case Reports
. 2020 Feb 19;28(3):185-187.
doi: 10.4103/JMU.JMU_73_19. eCollection 2020 Jul-Sep.

Ultrasound-Guided Superior and Middle Trunk Brachial Plexus Block with Superficial Cervical Plexus Block for Shoulder Surgeries in High-Risk Patients: Case Series

Vinodhadevi Vijayakumar  1 , Arimanickam Ganesamoorthi  1 , Nandhakumar Subramaniyan  1 , Parthiban Kasirajan  2
Affiliations
Case Reports

Ultrasound-Guided Superior and Middle Trunk Brachial Plexus Block with Superficial Cervical Plexus Block for Shoulder Surgeries in High-Risk Patients: Case Series

Vinodhadevi Vijayakumar et al. J Med Ultrasound. .

Abstract

There is a constant quest for a regional anesthetic technique that would provide anesthesia adequately for shoulder surgeries but lacks the complications of an interscalene block, such as phrenic nerve palsy. The nerves to be blocked for a surgery can be analyzed and tailored. We discuss the precise blockade of the superior and middle trunk of the brachial plexus along with superficial cervical plexus block using ultrasound for performing three different shoulder surgeries exclusively under regional anesthesia, in high-risk patients without any clinically observed complications.

Keywords: Brachial plexus block; middle trunk block; shoulder surgeries; superficial cervical plexus block; superior and middle trunk block; superior trunk block; ultrasound guided regional anesthesia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Sonoanatomy of the right side brachial plexus and the position of the ultrasound transducer in the neck are demonstrated. (a) Cervical root (C) 5, C6. SCM: Sternocleidomastoid, ASM: Anterior Scalene Muscle, MSM: Middle Scalene Muscle. (b) Emerging of C7 root (c) C5-C6 about to unite to form superior trunk. C7 continues as middle trunk. (d) Superior trunk formed, middle trunk divided into the anterior and posterior divisions. The yellow arrow indicates the trajectory the needle is passed in in-plane technique to block the middle trunk (C) and Superior trunk (D). The black arrow indicates parts of the brachial plexus
See this image and copyright information in PMC

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