Background and aims There is significant variation in the practise of the interscalene block (ISB). A survey was conducted aimed at assessing both adherence to published guidelines for consent and to obtain a profile on the extent of variation in techniques.
Methods The survey was emailed to anaesthetists of all grades at three large NHS trusts in the UK. Responses were collected anonymously and concerned consent, use of sedation/GA prior to the block, LA volume, nerve localisation methods, and complications.
Results 23 anaesthetists responded (50% consultants). Consent was most often obtained on the day (92%) and risks were mainly communicated verbally, with an information leaflet being used on occasion (15%). Prolonged block (57%) and bleeding (61%) were the least likely risks to be conveyed to the patient, whilst the possibility of failure was stated 100% of the time. Respondents indicated failure as the most common complication they observed in the past 5 years (38%) with no complications reported by 42%. The most common LA volume used was between 10 and 19 mL (75%) and ultrasound was reported as always used, with nerve stimulation in 17%. Preference in performing the block on an awake patient was reported by 58% of respondents, with the remainder under sedation (12%) or GA (30%).
Conclusions This limited survey reflects wide variations in the ISB practise, particularly with respect to proceeding with awake/GA/sedated patients and the information about risks given in the consent process. Further investigation about the need of standardisation of consent and performance of ISB is needed.
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