Friday, October 31, 2008

Today , this was our R n D

In the strong tradition of Sifu-Ling's Regional Anaesthesiasm , we did the Continuous Interscalene Brachial Plexus Block for a 73 year old man who was about to undergo a shoulder operation ; Rotator Cuff repair. The technique was more for post operative pain control rather than anaesthesia for procedure. The position for the patient can be really uncomfortable and that is the reason why we GA patients for this procedure. It is a common fact that knee and shoulder operations can be DAMN PAINFUL post op !!

According to NYSORA , he most difficult aspect of this technique is stabilization of the needle for catheter insertion after the brachial plexus is localized. This was Ling's first ever interscalene catheter insertion under ultrasound guidance. We did it meticulously and we were lucky Uncle was very cooperative ! he even laughed when his shoulder "moved" when we stimulated it !
Continuous nerve blocks require the use of larger needle gauges and thus intraarterial placement (e.g., carotid artery) has greater implications and IT IS NOT FUNNY !! That is why , ultrasound guidance is gold standard to do this procedure ..and WALAH !! MAlaysia Boleh !!

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