상박신경총 차단을 위한 Parascalene Technique ( 전사각근 측부접근법 ) 의 임상고찰

Background : Brachial plexus is invested by a fascial envelope, which forms a perineural and perivascular space that extends all the way from the cervical intervertebral foramen to the distal axilla. Therefore a single injection of a local anesthetic into any sites of this space can provide anesthesia of the entire brachial plexus. Nowadays many methods of brachial plexus block have been developed but there are some severe complications and they can't prevent tourniquet pain completely. Methods : We have performed parascalene technique for brachial plexus block in 206 cases from Jan., 1992 to Dec.,1994. We studied the cases retrospectively by reviewing patients' anesthesia records. The technique for parascalene block is the injection of local anesthetic solution into the lower part of the posterior triangle of the neck at the point 1.5∼2.0 cm above the clavicle at the lateral border of the anterior scalene muscle. Results : We could provide the proper anesthesia for the upper extremity and shoulder operation without any remarkable complications except Honor's syndrome of 3 cases. And there were no tourniquet pain in all 96 cases who had used tourniquet. Conclusions : The parascalene approach is the useful, safe and reliable method for brachial plexus block. (Korean J Anesthesiol 1997; 32: 782∼786)