Interscalene block for postoperative analgesia using only ultrasound guidance: the outcome in 200 patients.

STUDY OBJECTIVE: To report the results of single and continuous interscalene blocks (ISB) performed using ultrasound (US) guidance only.

DESIGN: Prospective, observational study.

SETTING: Operating room of a university-affiliated orthopaedic hospital.

PATIENTS: 200 ASA physical status I, II, and III patients undergoing shoulder or elbow surgery.

INTERVENTIONS: Single or continuous ISB were placed using US guidance only. All blocks were performed by anesthesiology residents and supervised by faculty anesthesiologists.

MEASUREMENTS: Success rate and frequency of untoward events such as needle paresthesia, vessel puncture, infection, and persistent neurologic deficits were prospectively recorded.

MAIN RESULTS: 99% of patients reported sensory and motor changes in the distribution of the brachial plexus and postoperative pain scores
CONCLUSIONS: In this group of 200 consecutive patients, the success rate for postoperative analgesia using US guidance only was 99%. Untoward events such as needle paresthesia and persistent neurologic deficits were lower than existing data on nerve stimulation and paresthesia techniques. Ultrasound can be successfully used as a "stand alone" method to perform ISB.