Shoulder Block: Part 3 of 3

[@Masterclass-rq4dy]

Great video Herman

[@deepakane5633]

you are doing a fantastic job Herman

[@abdulridhaalmajidi8153]

Thanks for this nice presentation

[@veryannoyingname]

Ok thanks. Will do some experimentation myself with MBe on different probes and check myself again. Will be interested in reading your case report please let me know when it's available. I haven't had issues with needle disappearing on MBe but I always keep it within dotted line. Will experiment on needling phantom and see what happens when crossed dotted line. Regards

[@pradyingle]

Thanks for the video Harman. I was getting a bit rusty and this came in quite handy when needed. Much appreciated .

[@elizabethsos5993]

Excellent!

[@michaelkornievsky3296]

Thank you! Excellent video.

[@hermansehmbi29]

Glad it was helpful!

[@veryannoyingname]

nice videos. Does your machine not have the MBe mode on page two of the options menu. You probably should have it since your machine had the MB shown on the screen. If you have it then MBe might make your needle more visible as your angle is steep to access the nerve for suprascapular.

[@jacunab]

Excellent Video and good explanation about the blocks Thank Dr Sehmabi.

[@tropiex2097]

Hello Herman, Thanks for Your videos! I’m an anesthesiologist, and now I’m going to study periferic tecnichs, I appreciate all the videos You have done. If possible I have a question about the shoulder anesthesia performed with axillary and supraclavicolar nerve block: is this tecnique usefull for complete protesis of the shoulder joint surgery? Thanks for Your actention, Happy new year Pietro from Florence

[@Xd_god94]

Thanks it's so interesting....

[@lisbethvallejos7732]

gracias!! me gustó mucho

[@bridgednash]

Thank you for posting this!

[@shairkomissouri8839]

Thank you Dr Sehmabi

[@veryannoyingname]

not sure i understood what you meant by part of the needle on the other side of the dotted line??? did you mean L to R flip??? option on the MBe or did u mean needle crossing the dotted line and going beyond. If the latter then once adjusting the steepness option on the MBe and adjusting probe position in most cases the needle should be in view in its entire length. 4-5cm depth with a linear probe in RES and NRV setting a 20g block needle should show & with curvilinear 2MHz a 20g wont show well

[@hermansehmbi29]

Look at sonosite manual, MBe mode, under Needle visualization, Page 31. Clearly mentions the area beyond the dotted line as unenhanced area. Hence the issue!

[@hermansehmbi29]

I referred to the needle crossing the dotted line. This 'zone of safety' is least on maximum steep angle, and most interfering then. If you change the steepness option to less steep, you may increase this zone of safety (within which the needle will be visible), but you will sub optimize visibility. This discussion is limited to HFL probe for now. I am in the process of describing this in a case report as of now. Will let you know when in publication.

[@mauriceomvitianduama4288]

Merci que Dieu vous bénisse

[@user-rn5xc8zi2q]

thank you!!excellant lecture~~

[@alexanderphilip1751]

Hi,great video.One question.To block the suprascapular nerve,do you have to penetrate the transverse scapular ligament itself?

[@hermansehmbi29]

no. Intending for that would be dangerous. Ensuring a spread along the scapular floor in the vicinity is all you need. usually 5-10 ml if enough.

[@hermansehmbi29]

Yes, this model did not have the MBe...the other one does have it. However..MBe mode is tricky as well...if part or the needle lies on the other side of the dotted line, its not enhanced and you have apart of needle with great visibility..and the other part with quite poor visibility. So, I am happy actually not using it.

[@dramirfarhadbahreini6477]

Very bad accent.and why you didn't show the nerve s