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Background and Aims The reported incidence of anatomical variation of the brachial plexus in the interscalene groove varies and is based on different cadaveric studies with unknown clinical effects on the regional block efficacy. This case describes the analgesic efficacy of superior trunk block for shoulder surgery in anatomically variant brachial plexus.
Methods A 58-year-old patient was booked for right shoulder joint replacement. The patient consented to receive general anaesthesia and a brachial plexus block for analgesia. Ultrasound-guided scanning of the interscalene groove at the level of C6 revealed an unusual anatomy with the superior trunk located anterior to the anterior scalene muscle (image 1). The superior trunk was blocked above the anterior scalene muscle with 5ml of 0.25% levobupivacaine injected anterior and 7ml posterior to it (image 1). Similar anatomical variation was also noted on the contralateral side (image 2). Written consent was obtained from the patient to publish this abstract.
Results Block effects are summarised in the table 1 below.
Conclusions This case report shows reduced analgesic efficacy of superior trunk block performed anterior to the anterior scalene muscle in the anatomically variant brachial plexus.
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