[Parascalene brachial plexus block].

The supraclavicular brachial plexus block originated by Kulenkampff is useful but accompanies the danger of injury to the lung, i.e. pneumothorax, because the needle is directed caudad. Reviewing the anatomy of the brachial plexus in cadavers, we have found that the parascalene brachial plexus block originated by Vongvises is safer than Kulenkampff's method. We modified this block as follows: (1) An assistant pulls lightly the affected upper extremity caudad. (2) A 23-gauge 35 mm needle is inserted at right angles to the clavicle and directed cephalad at an angle of 0-30 degrees. One hundred and eighty four ASA I and II patients were operated under this block. Their ages ranged from 11 to 77, and there were 31 patients whose cervical spinal cord had been injured. Our success rate was 92%. The only complication we encountered was Horner's syndrome which occurred in 20% of our cases. None of our patients showed clinical symptoms of pneumothorax, hematoma, epidural as well as subarachnoideal block, recurrent nerve paralysis or phrenic nerve paralysis.