Meghan Hughes

 A procedure in which an anesthetic agent is injected around the peripheral nerves of the brachial plexus in order to anesthetize the shoulder, lateral arm and lateral forearm  Usually for pain control or anesthesia during surgery

 Anesthesia during orthopedic surgeries of the shoulder and arm and post operative pain relief  Pain relief post amputation  Analgesia following limb ischemia, trauma, etc  Reduction of dislocated shoulders in the ED

 Position the patient  Identify landmarks  Using sterile technique, inject local anesthetic  Insert the needle using U/S or a nerve stimulator to ensure proper positioning  Inject anesthetic

 Positioning  The addition of magnesium sulfate or dexamethasone prolongs analgesia post op

 Damage to nerves or blood vessels  Infection  Horner’s Syndrome

 VanNorman GA. Interscalene Nerve Block. Procedures Consult. (2010). Retrieved from ner/projects/FullDetails.aspx?ProcedureId=271&procSN=AN- 023#0  Blaivas M, Adhikari S, Lander L. A Prospective Comparison of Procedural Sedation and Ultrasound-guided Interscalene Nerve Block for Shoulder Reduction in the Emergency Department. Academic Emerg Med. (2011) 18 (9): /j x  Cummings KC, et al. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. Br J Anesth. (2011) 107 (3): DOI /bja/aer159  Le AR, et al. Magnesium added to bupivacaine prolongs the duration of analgesia after interscalene nerve block. Can J Anesth. (2012) 59:21–27. DOI /s  