Interscalene block for shoulder surgery

Fracture dislocation of the shoulder is a common musculoskeletal injury following road traffic accident. Peripheral nerve block has become a recognized anesthetic technique due to the rapid onset of prolonged analgesia, sufficient for both pain and surgical management. However, interscalene block for shoulder surgery has not been reported as a primary anesthetic technique in our environment. We report its successful use in open reduction and internal fixation of left humeral surgical neck fracture dislocation. The interscalene brachial plexus were localized by a Polystim II nerve stimulator (te me na, Bondy, France) with sustained biceps motor response at 0.2 mA and 40 ml of local anesthetic, comprising 0.25% bupivacaine and 1.0% of lidocaine with 1 : 200 000 epinephrine in equal parts was administered to establish the block. Surgical anesthesia was achieved 18 minutes after instituting the block and surgery lasted 70 minutes without complications. This technique may obviate the use of general anesthesia with its risks.