where is brachial compared to antebrachial?

T1 radiculopathy: electrodiagnostic evaluation. Brachial vs Brachium - What's the difference? | WikiDiff Correspondence to The remaining local anesthetic is then injected subcutaneously in a cephalad and caudad direction along the posterior border of the sternocleidomastoid. Epub 2019 Jul 19. Aiming to control the symptoms, we started conservative management for her. 2008;22(2):24854. J Brachial Plex Peripher Nerve Inj. Complications of elbow arthroscopy. It bifurcates into the radial and ulnar arteries at the apex of the cubital fossa. Magnetic resonance imaging of the right elbow revealed faintly visualized signal changes in the proximal and posterior aspect of the medial collateral ligament (MCL) with no definite evidence of defect or tear. Brachial Fascia - an overview | ScienceDirect Topics Indeed, frequently the line of dye conformed to the shape of the surrounding anatomy (figs. Supraclavicular nerves, derived from C3C4 nerve roots, is not part of the brachial plexus, and provides sensory innervation of the shoulder cape.. The relevant anatomy will be covered with specific nerve block description. Third, it is said that supraclavicular techniques are more effective than axillary techniques because the nerves are closer together. Acondition that involves pressure or stretching of the ulnar nervewhich can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. As a noun antebrachium is (anatomy) the forearm. antebrachial ( A) Axial section of brachial plexus catheter. The brachial plexus is divided, proximally to distally into rami/roots, trunks, divisions, cords, and terminal Why Walden's rule not applicable to small size cations. Webantebrachial | brachial | As adjectives the difference between antebrachial and brachial is that antebrachial is relating to the forearm while brachial is pertaining or belonging to the arm. Antebrachial | definition of antebrachial by Medical Webthe axillary vein and the brachial vein [2]. Two patients with numbness and painful paresthesia over the medial aspect of the unilateral forearm were referred for electrodiagnostic study, which revealed MABC nerve lesion in each case, which strongly suggested that they were the result of direct nerve injury by an injection needle during previous brachial plexus block procedures. J Med Case Reports 17, 91 (2023). of the medial antebrachial cutaneous nerve FIGURE 2. Antebrachial vs Antebrachium. & Erfani, F. Isolated medial antebrachial cutaneous nerve injury after blunt trauma: a case report. The images of the two catheter systems were the same, with the exception that one was of the upper extremity and the other was of the lower extremity. ( B) Coronal section of sciatic nerve catheter. Local anesthetic spread in an interscalene plexus block often blocks the cervical plexus and therefore it is adequate to block the supraclavicular nerve, but the nerve is frequently not anesthetized with a supraclavicular brachial plexus block. Communication between the radial nerve and medial cutaneous nerve of forearm on the left side in a 58-year-old male cadaver is reported and neurosurgeons should keep such variations in mind while performing the surgeries of axilla and upper arm. Three to 5 mL of local anesthetic is injected when a paresthesia to the hand is elicited. The concept of the brachial plexus sheath seems to describe the anatomy inaccurately. J Plast Reconstr Aesthet Surg. Clinical, electrodiagnostic and imaging features of true neurogenic thoracic outlet syndrome: Experience at a tertiary referral center. A case of isolated tuberculoid leprosy of antebrachial medial cutaneous nerve. Two patients with N-TOS presented with paresthesia of unilateral arm, and examination revealed no neurologic deficits, and electrophysiologic studies including MABC NCS were normal. Unable to load your collection due to an error, Unable to load your delegates due to an error. The cubital fossa is an area of transition between the anatomical arm and the forearm. For example, block of the musculocutaneous nerve must be performed in the axilla to render motor block of the biceps and brachioradialis muscles. 3. Selective elbow blocks are inferior alternatives to brachial plexus blocks. 2017;70(11):15828. 2020 Aug 13;5:173-193. doi: 10.1016/j.cnp.2020.07.005. FOIA She had a history of blunt trauma to her right forearm about 40days before the first evaluation. Would you like email updates of new search results? The median nerve is more superficial and identified by a needle placed just medial to the brachial artery. It provides cutaneous innervation to the lateral (radial) half of the volar forearm. She was nulliparous. ant--, an-ti-. Electromyogr Clin Neurophysiol. Reg Anaesth Pain Med 2003; 28:336, Lanz EL, Theiss D, Jankovic D: The extent of blockade following various techniques of brachial plexus block. Google Scholar. Superior borderis an imaginary line between the epicondyles of the humerus. 1 and Table 1). PubMed Central 2019 Feb 1; [PubMed PMID: 30716466], Kwon K,Shin BS,Chung MS,Chung BS, New Viewpoint of Surface Anatomy Using the Curved Sectional Planes of a Male Cadaver. There was no complaint of weakness in the affected limb. Journal of Medical Case Reports A low ankle-brachial index Surface landmarks are identified by drawing one line along the superior border of the scapular spine and then bisecting it with a second line drawn parallel with the vertebral spine. the brachial and antebrachial fasciae form a unique sheath that might be compared to an evening glove, proximally tensioned by the various myofascial In follow-up sensory nerve conduction study of the right MABC nerve, the latency on the right side was delayed by 5.00 ms compared to 2.50 ms on the unaffected left side, and the amplitude on the right side showed an abnormally reduced value of 2.9 V compared The nerve becomes superficial as it penetrates the mid belly of the sternocleidomastoid muscle, thereafter forming three branches (Figure 3). The first 5 mL of local anesthetic is injected just deep to the lateral margin of the biceps tendon; the second 5 mL area injected subcutaneously and lateral from the first injection site, along the elbow crease (Figure 7). Plast Reconstr Surg. Then, 20 ml of 50% diluted Omnipaque dye was injected down each catheter, and the patients were rescanned at a slice thickness of 3 mm and a pitch of 2. Anatomic course of the medial cutaneous nerves of the arm. Three milliliters is deposited with a 22- to 25-gauge sharp needle into the mid belly of the sternocleidomastoid. brachial . lateral side and the ulna on the medial side. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. When LAC and/or MAC nerve blocks are supplemental to a previous incomplete brachial plexus block, the additional 1520 mL of local anesthetic should be well tolerated by patients if injected 2030 minutes after the primary block. Ma CX,Pan WR,Liu ZA,Zeng FQ,Qiu ZQ,Liu MY, Deep lymphatic anatomy of the upper limb: an anatomical study and clinical implications. 2011 Dec;35(6):807-15. doi: 10.5535/arm.2011.35.6.807. Wiki User. Considering the unpredictable overlap of forearm cutaneous innervation, it is advisable to perform both LAC and MAC nerve blocks when forearm anesthesia is desired. Median cubital vein connects the basilic and cephalic veins and can be accessed easily. MeSH The following observations relate to figures 14. London, Longmans, Green, 1967, p 1227, Carlson GW: Surgical anatomy of the neck. The carpal region is the Tissue planes are fundamental to surgical dissection technique,12but perhaps they are not sufficiently emphasized in anesthetic practice, given the number of publications in the literature that describe them.5,6,1316. 2004 Oct;115(10):2316-22. doi: 10.1016/j.clinph.2004.04.023. 2009 Feb;5(1):73-7. doi: 10.1007/s11420-008-9105-4. Blunt trauma can be one of the causes of medial antebrachial cutaneous nerve involvement. Antebrachial vs Brachial - What's the difference? | WikiDiff Search for other works by this author on: Reding M: Nouvelle mthode d'anesthsie rgionale du membre suprieur. Different variations were reported in the anatomical course of this nerve [2, 6, 7]. The Journal of bone and joint surgery. Clinical, Electrophysiological Findings in Adult Patients with Non-traumatic Plexopathies. Before See answer (1) Best Answer. statement and WebMethods: We compared the medial antebrachial cutaneous sensory nerve action potential amplitude with the median motor, ulnar motor, and ulnar sensory NCS amplitudes in 10 Ballard T, Smith T. Anatomy, medial antebrachial cutaneous nerve. PhilipB. Cornish, M.B., Ch.B., F.A.N.Z.C.A. Cervical rib and median sternotomy-related brachial - PubMed Axillary block procedure guide - UpToDate This is a less than convincing argument because the nerves are not far apart at either level. The medial antebrachial cutaneous (MAC) nerve is a branch of the brachial plexus that carries fibers of C8T1 segments [1, 2]. 2021 Oct 14;11(10):1896. doi: 10.3390/diagnostics11101896. Definition. Range of motion, manual muscle testing, and deep tendon reflexes were normal. Diagnostics (Basel). If intermediate-acting local anesthetics are selected (lidocaine or mepivacaine), the duration can be increased with either adjuvant epinephrine (2.5 mcg/mL). By using this website, you agree to our ZB processed the data and significantly contributed to writing and editing the manuscript. 2021. WebEnter two words to compare and contrast their definitions, origins, and synonyms to better understand how those words are related. Although the most common type of male and female was different as type I and type II, respectively, there is no statistical difference between them. Yildiz N. Medial antebrachial cutaneous neuropathy in a teacher: a case report. A tissue plane is a potential space of embryologic origin that separates muscular and/or visceral compartments and that provides space for transmission of arteries, veins, lymphatics, and nerves between these compartments. THE axillary or brachial plexus sheath has been a fundamental tenet of regional anesthesia applied anatomy for many years.14More recently, however, some doubt has been cast on the precise nature and existence of the sheath.58In the context of this controversy, we sought to find an alternative way to try to further the debate. The position of the catheter tips was determined by a radiologist (C.L.) needle that is placed just medial to the brachial artery at the level of the epicondyles (see Figure 8). Their use as a supplement to incomplete plexus block should be carefully considered. Complications of the supraclavicular nerve block are uncommon. Radial and median nerves are approached at the level of the epicondyles. 2017 Nov 15; [PubMed PMID: 29140886], Anatomy, Shoulder and Upper Limb, Elbow Cubital Fossa. WebBrachial Antebrachial Humerus Anatomical neck of the humerus Surgical neck of the humerus Shaft of the humerus Greater tubercle (the bony ridge on top of you shoulder) Although most upper extremity regional anesthesia is accomplished by means of various approaches to the brachial plexus, there are occasions when individual terminal nerves or their branches are blocked selectively. al ant-i-br-k-l. Blunt trauma can be one of the causes of MAC nerve involvement. The brachial pulse may be palpated in the cubital fossa just medial to the tendon. MACN neuropathy should be taken into account for the differential diagnosis of the patients with complaints of pain and dysestesia in medial forearm and anteromedial aspect of the elbow. Eur J Anaesthesiol 1994; 11:3916, Klaastad O, Smedby O, Thompson GE, Tillung T, Hol PK, Rotnes JS, Brodal P, Breivik H, Hetland KR, Fosse ET: Distribution of local anesthetic in axillary brachial plexus block: A clinical and magnetic resonance imaging study. The radial nerve supplies sensation to the dorsum of the forearm and hand (see Figures 1 and 2); it also innervates the musculature of the dorsal forearm. Cutaneous Blocks for the Upper Extremity Landmarks and Nerve Stimulator Technique. In the literature, some reported causes of MAC nerve involvement include brachial plexopathy [8] and thoracic outlet syndrome [9]. She complained of difficulty in writing due to this annoying dysesthesia. By clicking accept or continuing to use the site, you agree to the terms outlined in our. A series of plain x-ray film dye studies3,19,20have shown containment of solution, but plain x-ray films do not adequately define nonbony structures, and they lack the three-dimensional perspective of computerized tomography scanning. Blocking the LAC is accomplished with two local anesthetic injections placed along the intercondylar line. Privacy These symptoms are often felt when the elbow is bent for an extended period of time, such as while holding a phone or while sleeping. Morphologie : bulletin de l'Association des anatomistes. An observational study has been performed using US imaging to measure brachial and antebrachial fasciae thickness at anterior and posterior regions, Did Billy Graham speak to Marilyn Monroe about Jesus? Clipboard, Search History, and several other advanced features are temporarily unavailable. 8600 Rockville Pike When was AR 15 oralite-eng co code 1135-1673 manufactured? Introduction. Recent investigations have cast doubt on its nature and existence. An example of data being processed may be a unique identifier stored in a cookie. Webantebrachial flexor retinaculum; antebrachial region; anterior compartment of forearm; anterior interosseous nerve; anterior region of forearm; antibrachial; antibrachium; Biceps brachii / long head short head, tendon of biceps brachii, bicipital aponeurosis. Ann Vasc Surg. Brachial Thomas K, Sajjad H, Bordoni B. Anatomy, shoulder and upper limb, medial brachial cutaneous nerve. Anaesth Intensive Care 1979; 7:3469, An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration, A Tool to Screen Patients for Obstructive Sleep Apnea, ACE (Anesthesiology Continuing Education), https://doi.org/10.1097/00000542-200609000-00021, 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway, 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting DurationA Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting, Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures, Atrophy of Diaphragm and Pectoral Muscles in Critically Ill Patients, Pectoral Nerve Blocks for Breast Augmentation Surgery: A Randomized, Double-blind, Dual-centered Controlled Trial, Optic Nerve Sheath Diameter Used as Ultrasonographic Assessment of the Incidence of Raised Intracranial Pressure in Preeclampsia: A Pilot Study. BioMed research international. The plan is to stretch a rope vertically from the engine to a branch of a tree $6.0 \mathrm{~m}$ above, and back to the bumper. It provides cutaneous innervation to the medial (ulnar) half of the volar forearm, an area commonly misperceived as innervated by the ulnar nerve (see Figures 1 and 2). 2017 Jun;55(6):782-793. doi: 10.1002/mus.25536. 11, 12 Rosen There are several reasons why the tissue plane is important anatomy to understand. The consent submitted will only be used for data processing originating from this website. Medial and lateral antebrachial cutaneous nerve blocks are useful techniques for superficial volar forearm procedures, such as arteriovenous fistula creation. sharing sensitive information, make sure youre on a federal In conclusion, this study suggests that there may not be an enveloping and encasing soft tissue structure, or sheath, around the brachial plexus. There are generally three instances in which the anesthesiologist desires to perform these selective nerve blocks. Pneumothorax can result from a needle that passes through the suprascapular notch and enters the pleural space. Anesth Analg 1983; 62:558, Urmey WF, Talts KH, Sharrock NE: One hundred per cent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Mild tenderness in the anteromedial part of the elbow was detected. 2017; [PubMed PMID: 29391938], Mukai K,Nakajima Y,Nakano T,Okuhira M,Kasashima A,Hayashi R,Yamashita M,Urai T,Nakatani T, Safety of Venipuncture Sites at the Cubital Fossa as Assessed by Ultrasonography. The solid white arrowsindicate the dye-enhanced nerves. Although potential ulnar nerve entrapment can occur at multiple points along its course, for example, the Arcade of Struthers, the medial intermuscular septum, the medial epicondyle, the cubital tunnel, and the deep flexor pronator aponeurosis, the most common site of entrapment is the cubital tunnel. 2B, 3, and 4). Horowitz SH. Pakistan ka ow konsa shehar ha jisy likhte howy pen ki nuk ni uthati? Fig. Brachial Plexus Compressive / Entrapment | PM&R KnowledgeNow The supraclavicular nerve provides sensory innervation to 70% of the posterior-superior shoulder joint, the acromioclavicular joint, and a portion of the anterior axilla in up to 10% of patients. WebMedial Antebrachial Cutaneous Nerve Injury www.e-arm.org 915 relieved slightly. Suprascapular nerve block (SSNB) can be used as an adjunct to arthroscopic shoulder surgery and total shoulder arthroplasty. The right elbow X-ray was normal. JBJS. Patients should be informed to protect their insensate limb from external pressure or temperature extremes. It is suggested that only 23 mL of local anesthetic be injected to avoid excessive pressure within the tight fascial space of the ulnar groove and thereby lessen the possibility of compromising neural blood flow. The dynamics of spread have the potential to be quite different18from those one might expect from a simple tubular structure such as a sheath. The two patients with sciatic nerve catheters had these inserted in similar fashion to the technique described by Sutherland.10Both had undergone major ankle surgery using combined general anesthesia and regional nerve blocks. Anaesth Intensive Care 2000; 28:6769, Sutherland ID: Continuous sciatic nerve infusion: Expanded case report describing a new approach. Intercostobrachial nerve block. Motor NCS of the median and ulnar nerves was normal. The Sheath of the Brachial Plexus | Anesthesiology | American Clin Neurophysiol. This site needs JavaScript to work properly. Blocks of the lateral and medial antebrachial cutaneous nerve. Ulnar nerve block at the elbow. Median nerve block at the elbow is accomplished with a 1.5-in. J Neurol Sci. [Removal of the 1st rib in thoracic outlet syndrome. Article J Reconstr Microsurg. WebThe ante-brachial fascia arises as a direct continuation of the brachial fascia in its inferior section (Fig 36.16). 2004;115(10):231622. It is located in a depression on the anterior surface of the elbow joint. An observational study has been performed using US imaging to measure brachial and antebrachial fasciae thickness at anterior and posterior regions, respectively, of the arm The purpose of this study was to measure and compare, by US imaging, the thickness of deep/muscular fasciae in different points of the arm and forearm. Anesthetizing the skin of the medial forearm requires block of the MAC nerve, not the ulnar nerve at the elbow. It is responsible for the medial side of the forearm and olecranon skin sensation [3, 4]. Finally, the advent of ultrasound-guidance has substantially facilitated performance of cutaneous blocks. The objective of this study was to identify electrodiagnostic and anatomic distinctions between true neurogenic thoracic outlet syndrome and median sternotomy-related brachial plexopathy, in reference to the pattern of abnormality of the medial antebrachial cutaneous sensory nerve conduction study (NCS) response. The catheters were inserted to a depth of 1215 cm from skin to catheter tip. FIGURE 8. Arch Phys Med Rehabil. Is it helpful? Google Scholar. Do Eric benet and Lisa bonet have a child together? Moreover, regarding the posterior region/levels, the brachial fascia had a greater thickness (mean 0.81 0.20 mm) than the antebrachial fascia (mean 0.71 0.20 mm); regarding the anterior region/levels, the antebrachial fascia was thicker (mean 0.70 0.2 mm) than the brachial fascia (mean 0.61 0.11 mm). The https:// ensures that you are connecting to the A copy of the written consent is available for review by the Editor-in-Chief of this journal. Clin Neurophysiol Pract. View 2 excerpts, cites background and methods, Journal of Brachial Plexus and Peripheral Nerve Injury. The median nerve provides sensation to the radial palm, the proximal fingers from the thumb to the long finger, and motor control to the forearm flexors (see Figures 1 and 2). The three patients with brachial plexus catheters had these inserted using the bent needle technique of supraclavicular block,9and all had undergone major wrist, elbow, or forearm surgery during regional anesthesia, followed by regional analgesia using their catheters. In the literature, MAC nerve involvement has been reported to have various mechanisms. Text is available under the Creative Commons Attribution/Share-Alike License; additional terms may apply.See Wiktionary Terms of Use for details. Quizlet anterbrachium is the forearm,region between elbow and the wrist while brachium is the arm,region between shoulder and the elbow. When considering the application of these various blocks, the reader is reminded that innervation of the upper extremity is often variable and overlapping. The resulting ischemia can cause Volkmanns ischaemic contracture. Also, compound nerve action potential (CNAP) of the ulnar nerve across the elbow by stimulating the wrist and recording above the elbow showed mild conduction block on the right side compared with the left. This variation underlines the importance of using the intravenous illuminator for venipuncture. Antebrachium Techniques for anesthetizing the LAC and MAC nerves involveonly superficial injection of local anesthetic; thus the risk of nerve injury is very low. The first treatment is to avoid actions that cause symptoms. The pattern of distribution of dye within the neural tissues was similar between the two systems, both in the region of the catheter tip and at the extremes of dye distribution. Medial brachial and antebrachial cutaneous nerve injuries: effect on outcome in revision cubital tunnel surgery. On needle electromyography of the right flexor carpi ulnaris and first dorsal interosseous, there was normal motor unit action potential (MUAP) and recruitment without spontaneous activity. Proximal techniques of brachial plexus block are often superior to selective nerve block at the elbow because the latter are more difficult to perform, are more time-consuming and uncomfortable, and potentially carry a greater risk of complications. It goes along the course of the median and ulnar nerves, vena basilica, and arteria brachialis, in the upper arm [ 1 ]. FIGURE 5. Muscle Nerve. Within the roof runs the median cubital vein, which can be accessed for venipuncture (see clinical significance below). J Neurosci Rural Pract. The antebrachium is the forearm. while brachium is the arm,region between shoulder and the elbow. At the supraclavicular level, however, the elements of the plexustrunks, divisions, and cordsinterlace and interlink, and hence the connective tissues containing these nerves interconnect, a feature observed when they are dissected.8This interconnection would allow for a more even spread of injected solution, a phenomenon that is observed clinically.21This is distinctly different at the axillary level, where the terminal nerves do not interconnect and the connective tissues surrounding them create distinct compartments for each.16Fourth, side effect profiles may be explained by the interconnection, via tissue planes, of the anatomical compartments across which the nerves travel. What is the difference of antebrachium and the brachium? PMC The catheters were inserted to a depth of 1011 cm from skin to catheter tip. The suprascapular nerve (C4C5) branches from the superior trunk of the brachial plexus and, therefore, it is usually anesthetized by an interscalene block. Neurogenic thoracic outlet syndrome shows predominant damage in the T1 distribution, whereas sternotomy-related brachial plexopathy shows predominant damage in the C8 distribution, suggesting that these lesions are localized at the level of the anterior primary rami of the cervical roots, and not in the lower trunk of the brachial plexus. The artery runs medial to the biceps tendon. FIGURE 6. F-wave of the abductor digiti minimi was normal. Epub 2008 Dec 13. With the approval of the Nelson-Marlborough Ethics Committee (Nelson, New Zealand) and written informed consent, three patients with functioning brachial plexus catheters and two patients with functioning sciatic nerve catheters were enrolled in the study. HHS Vulnerability Disclosure, Help PubMed Complications of pseudoaneurysms can cause a serious threat to the afflicted limb and the patient's life. Manage Settings After identification of the ulnar groove, a short needle is placed approximately 1 cm proximal to the epicondyles and directed distally. Antebrachial Article Study now. Neither adjuvant significantly increases duration if a long-acting local anesthetic such as bupivacaine or ropivacaine is chosen. The ethics committee approved this study with the reference number IR.SUMS.MED.REC.1401.112. Brachial 2016;7(03):4436. Brachium and Antebrachium Flashcards | Quizlet Springer Nature. This study further examines the issue. The light touch and pinprick sensation were impaired on the medial side of the right forearm. It can also happen by falling onto a flexed elbow, but this accounts for less than 5% of cases.The displaced fracture fragments may impinge and damage the contents of the cubital fossa. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. 2018 Mar 28; [PubMed PMID: 29599380], Sadeghi A,Setayesh Mehr M,Esfandiari E,Mohammadi S,Baharmian H, Variation of the cephalic and basilic veins: A case report. What is sunshine DVD access code jenna jameson? AA visited the patient and did the electrodiagnostic study and analysis. Ankle-brachial index - Mayo Clinic The cubital fossa contains four main vertical structures from lateral to medial.[5][6][7][8]. Careers. Anesthesiology 2002; 96:131524, Cornish PB, Leaper CJ: The axillary tunnel: Redefining the limits of spread for brachial plexus blockade (abstract). 1996 Dec;67(12):1034-7. doi: 10.1007/s001150050089. The medial antebrachial cutaneous nerve is a branch of the brachial plexus that contains C8T1 segments. Brachial artery pseudoaneurysmsare a pulsatile hematoma caused by hemorrhage on soft tissues. J Hand Surg. Where Is The Brachial And Antebrachial? - Caniry For instance, the practitioner may rather choose the midhumeral brachial plexus block, where selective application of clonidine or low concentration of long-acting local anesthetics to the median and ulnar nerves prolongs analgesia without concomitant prolongation of motor block. Suprascapular nerve block does not add value to open shoulder procedures in which an interscalene block is the primary anesthetic. Kim SW, Jeong JS, Kim BJ, Choe YH, Yoon YC, Sung DH.

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