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PAIN MANAGEMENT PROCEDURE NOTEЉ
Procedure: Interscalene brachial plexus Block (64415) Ultrasound guided (76942)
Indication: In consultation with FORMDROPDOWN , an interscalene brachial plexus Block (64415) block was recommended to the patient for postoperative analgesia following FORMDROPDOWN FORMDROPDOWN .
Anesthesia: FORMDROPDOWN Assistant: FORMDROPDOWN
Informed consent was provided. Benefits of, and alternatives to the procedure were discussed, and the following risks were delineated, but were not limited to:
Block Failure FORMCHECKBOX , Nerve injury FORMCHECKBOX , Infection FORMCHECKBOX , Procedural discomfort FORMCHECKBOX , Accidental intravascular injection (seizure, arrhythmia, death) FORMCHECKBOX , Allergic reactions FORMCHECKBOX , Hematoma / bleeding FORMCHECKBOX , Pneumothorax FORMCHECKBOX . All questions were answered, and the patient wished to proceed.
A TIME OUT was performed verifying correct procedure and site. Standard monitoring was instituted using: EKG, NIBP, SPO2. Nasal O2 at 2L/min was administered. Conscious sedation was achieved with intravenous FORMDROPDOWN and FORMDROPDOWN . Patient remained responsive and cooperative throughout the entire procedure. Skin was prepped with FORMDROPDOWN . The needle insertion site was anesthetized with FORMDROPDOWN . Regional blockade was performed with an FORMDROPDOWN 22g blunt tip regional needle. The brachial plexus was located using ultrasound guidance. The needle was advanced using an in plane view and the needle tip was visualized throughout, guided to the perineural space. Regional vessels were identified and avoided. The pleura was not traversed. The patient did not complain of any paresthesias or pain during needle placement. Once the nerve roots were identified, FORMDROPDOWN was injected in 5ml increments with minimal resistance and no reported discomfort. Repeated aspirations excluded intravascular location. A total volume of FORMDROPDOWN was injected, and spread around the plexus was confirmed. An image was saved to the chart.
Sterile technique was maintained and vital signs remained stable throughout. The patient tolerated the procedure well. There were signs and symptoms of a solid block within 15-20 minutes. No complications were noted. Instructions related to the care of an insensate limb and possible side-effects of the block were provided to the patient and his/her responsible parties.
Notes:
Date / Time FORMDROPDOWN
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