Research Article
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Year 2020, Volume: 33 Issue: 3, 141 - 145, 23.10.2020
https://doi.org/10.5472/marumj.816311

Abstract

References

  • Harry WG, Bennett JD, Guha SC. Scalene muscles and the brachial plexus: anatomical variations and their clinical significance. Clin Anat 1997;10:250-2. doi:10.1002/ (SICI)1098-2353(1997)10:4
  • Cash CJ, Sardesai AM, Berman LH, et al. Spatial mapping of the brachial plexus using three-dimensional ultrasound. Br J Radiol 2005;78(936):1086-94. doi:10.1259/bjr/36348588
  • Chin KJ, Niazi A, Chan V. Anomalous brachial plexus anatomy in the supraclavicular region detected by ultrasound. Anesth Analg 2008;107:729-31. doi: 10.1213/ane.0b013e31817dc887
  • Gutton C, Choquet O, Antonini F, Grossi P. Ultrasoundguided interscalene block: influence of anatomic variations in clinical practice (French). Ann Fr Anesth Reanim 2010; 29: 770-5. doi: 10.1016/j.annfar.2010.07.013
  • Kapral S, Greher M, Huber G, Willschke H, Kettner S, Kdolsky R, et al. Ultrasonographic guidance improves the success rate of interscalene brachial plexus blockade. Reg Anesth Pain Med 2008;33:253–8. doi: 10.1016/j.rapm.2007.10.011
  • Kessler J, Gray AT. Sonography of scalene muscle anomalies for brachial plexus block. Reg Anesth Pain Med 2007;32:172- 3. doi: 10.1016/j.rapm.2006.09.011
  • Feigl GC, Pixner T. Combination of variations of the interscalene gap as a pitfall for ultrasound-guided brachial plexus block. Reg Anesth Pain Med 2011;36:523–4. doi: 10.1097/AAP.0b013e31822897f1
  • Abrahams MS, Panzer O, Atchabahian A, et al. Case Report: Limitation of Local Anesthetic Spread During Ultrasound- Guided Interscalene Block. Description of an Anatomic Variant With Clinical Correlation. Reg Anesth Pain Med 2008;33:357-9. doi:10.1016/j.rapm.2008.01.015
  • Feigl GC, Litz RJ, Marhofer P. Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy. Reg Anesth Pain Med.2020;45:620-7. doi: 10.1136/rapm-2020-101435
  • Feigl GC, Pixner T. The cleidoatlanticus muscle: a potential pitfall for the practice of ultrasound guided interscalene brachial plexus block. Surg Radiol Anat 2011; 33: 823–5. doi: 10.1007/s00276.011.0820-z
  • Kilicaslan A, Gürkan Y, Tekin M. A brachial plexus variation identified during ultrasound-guided interscalene block. Agri 2012; 24: 194. doi: 10.5505/agri.2012.34966
  • Koscielniak-Nielsen ZJ. Ultrasound-guided peripheral nerve blocks: what are the benefits? Acta Anaesthesiol Scand 2008;52:727-37. doi: 10.1111/j.1399-6576.2008.01666.x
  • Leonhard V, Smith, R, Caldwell, G, Smith, HF . Anatomical variations in the brachial plexus roots: implications for diagnosis of neurogenic thoracic outlet syndrome. Annals of Anatomy 2016;206: 21–6. doi.org/10.1016/j.aanat.2016.03.011
  • Sakamoto Y. Spatial relationships between the morphologies and inner-vations of the scalene and anterior vertebral muscles. Ann Anat 2012 ;194:381-8. doi.org/10.1016/j. aanat.2011.11.004
  • Yadav N, Saini N, Ayub A.Anatomical variations of interscalene brachial plexus block: Do they really matter? Saudi J Anaesth 2014;8:142-3. doi: 10.4103/1658-354X.125981
  • VadeBoncouer TR, Weinberg GL, Oswald S, Angelov F. Early detection of intravascular injection during ultrasound-guided supraclavicular brachial plexus block. Reg Anesth Pain Med 2008;33:278–9. doi: 10.1016/j.rapm.2007.12.012

Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications

Year 2020, Volume: 33 Issue: 3, 141 - 145, 23.10.2020
https://doi.org/10.5472/marumj.816311

Abstract

Objective: Our aim was to evaluate the anatomic variations detected during ultrasound-guided interscalene brachial plexus block
(US-ISB) and present their clinical implications.
Materials and Methods: After the ethical approval for the study was obtained from the local ethics committee, the files and US records
of patients who underwent US-ISB for anesthesia of the shoulder surgery were retrospectively analyzed.
Results: Anatomical variations which were considered to affect the block technique were detected in 13 (11.8%) of 110 patients. C5
cervical root pierced the anterior scalene muscle (ASM) in 4.5%, and ventral rami of C5 and/or C6 were located in ASM in 3.6% of
patients. There was a muscle bridge between C5 to C6 and C5 to C7 roots in 1.8% of the patients. The brachial plexus was located
medial to ASM and missing from interscalene groove in 1.8% of patients. In one case (C5 root was located in ASM), US-ISB resulted
in incomplete brachial plexus anesthesia, and so general anesthesia (GA) was performed.
Conclusion: Some of the brachial plexus variations in the interscalene area may be associated with further needle manipulation/
redirection and block failure. We consider that prospective studies including more populations are needed to elucidate the effects of
these variations on block parameters.

References

  • Harry WG, Bennett JD, Guha SC. Scalene muscles and the brachial plexus: anatomical variations and their clinical significance. Clin Anat 1997;10:250-2. doi:10.1002/ (SICI)1098-2353(1997)10:4
  • Cash CJ, Sardesai AM, Berman LH, et al. Spatial mapping of the brachial plexus using three-dimensional ultrasound. Br J Radiol 2005;78(936):1086-94. doi:10.1259/bjr/36348588
  • Chin KJ, Niazi A, Chan V. Anomalous brachial plexus anatomy in the supraclavicular region detected by ultrasound. Anesth Analg 2008;107:729-31. doi: 10.1213/ane.0b013e31817dc887
  • Gutton C, Choquet O, Antonini F, Grossi P. Ultrasoundguided interscalene block: influence of anatomic variations in clinical practice (French). Ann Fr Anesth Reanim 2010; 29: 770-5. doi: 10.1016/j.annfar.2010.07.013
  • Kapral S, Greher M, Huber G, Willschke H, Kettner S, Kdolsky R, et al. Ultrasonographic guidance improves the success rate of interscalene brachial plexus blockade. Reg Anesth Pain Med 2008;33:253–8. doi: 10.1016/j.rapm.2007.10.011
  • Kessler J, Gray AT. Sonography of scalene muscle anomalies for brachial plexus block. Reg Anesth Pain Med 2007;32:172- 3. doi: 10.1016/j.rapm.2006.09.011
  • Feigl GC, Pixner T. Combination of variations of the interscalene gap as a pitfall for ultrasound-guided brachial plexus block. Reg Anesth Pain Med 2011;36:523–4. doi: 10.1097/AAP.0b013e31822897f1
  • Abrahams MS, Panzer O, Atchabahian A, et al. Case Report: Limitation of Local Anesthetic Spread During Ultrasound- Guided Interscalene Block. Description of an Anatomic Variant With Clinical Correlation. Reg Anesth Pain Med 2008;33:357-9. doi:10.1016/j.rapm.2008.01.015
  • Feigl GC, Litz RJ, Marhofer P. Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy. Reg Anesth Pain Med.2020;45:620-7. doi: 10.1136/rapm-2020-101435
  • Feigl GC, Pixner T. The cleidoatlanticus muscle: a potential pitfall for the practice of ultrasound guided interscalene brachial plexus block. Surg Radiol Anat 2011; 33: 823–5. doi: 10.1007/s00276.011.0820-z
  • Kilicaslan A, Gürkan Y, Tekin M. A brachial plexus variation identified during ultrasound-guided interscalene block. Agri 2012; 24: 194. doi: 10.5505/agri.2012.34966
  • Koscielniak-Nielsen ZJ. Ultrasound-guided peripheral nerve blocks: what are the benefits? Acta Anaesthesiol Scand 2008;52:727-37. doi: 10.1111/j.1399-6576.2008.01666.x
  • Leonhard V, Smith, R, Caldwell, G, Smith, HF . Anatomical variations in the brachial plexus roots: implications for diagnosis of neurogenic thoracic outlet syndrome. Annals of Anatomy 2016;206: 21–6. doi.org/10.1016/j.aanat.2016.03.011
  • Sakamoto Y. Spatial relationships between the morphologies and inner-vations of the scalene and anterior vertebral muscles. Ann Anat 2012 ;194:381-8. doi.org/10.1016/j. aanat.2011.11.004
  • Yadav N, Saini N, Ayub A.Anatomical variations of interscalene brachial plexus block: Do they really matter? Saudi J Anaesth 2014;8:142-3. doi: 10.4103/1658-354X.125981
  • VadeBoncouer TR, Weinberg GL, Oswald S, Angelov F. Early detection of intravascular injection during ultrasound-guided supraclavicular brachial plexus block. Reg Anesth Pain Med 2008;33:278–9. doi: 10.1016/j.rapm.2007.12.012
There are 16 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Articles
Authors

Alper Kılıcaslan This is me 0000-0002-2570-5854

Funda Gok This is me 0000-0002-4968-1420

Ismail Hakkı Korucu This is me 0000-0002-3566-9391

Asiye Ozkan This is me 0000-0001-5419-8823

Resul Yılmaz This is me 0000-0002-5527-2893

Publication Date October 23, 2020
Published in Issue Year 2020 Volume: 33 Issue: 3

Cite

APA Kılıcaslan, A., Gok, F., Korucu, I. H., Ozkan, A., et al. (2020). Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Medical Journal, 33(3), 141-145. https://doi.org/10.5472/marumj.816311
AMA Kılıcaslan A, Gok F, Korucu IH, Ozkan A, Yılmaz R. Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Med J. October 2020;33(3):141-145. doi:10.5472/marumj.816311
Chicago Kılıcaslan, Alper, Funda Gok, Ismail Hakkı Korucu, Asiye Ozkan, and Resul Yılmaz. “Anatomical Variations Detected During Ultrasound-Guided Interscalene Brachial Plexus Block and Clinical Implications”. Marmara Medical Journal 33, no. 3 (October 2020): 141-45. https://doi.org/10.5472/marumj.816311.
EndNote Kılıcaslan A, Gok F, Korucu IH, Ozkan A, Yılmaz R (October 1, 2020) Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Medical Journal 33 3 141–145.
IEEE A. Kılıcaslan, F. Gok, I. H. Korucu, A. Ozkan, and R. Yılmaz, “Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications”, Marmara Med J, vol. 33, no. 3, pp. 141–145, 2020, doi: 10.5472/marumj.816311.
ISNAD Kılıcaslan, Alper et al. “Anatomical Variations Detected During Ultrasound-Guided Interscalene Brachial Plexus Block and Clinical Implications”. Marmara Medical Journal 33/3 (October 2020), 141-145. https://doi.org/10.5472/marumj.816311.
JAMA Kılıcaslan A, Gok F, Korucu IH, Ozkan A, Yılmaz R. Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Med J. 2020;33:141–145.
MLA Kılıcaslan, Alper et al. “Anatomical Variations Detected During Ultrasound-Guided Interscalene Brachial Plexus Block and Clinical Implications”. Marmara Medical Journal, vol. 33, no. 3, 2020, pp. 141-5, doi:10.5472/marumj.816311.
Vancouver Kılıcaslan A, Gok F, Korucu IH, Ozkan A, Yılmaz R. Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Med J. 2020;33(3):141-5.