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Ultrasound‐guided spinal accessory nerve blockade in the diagnosis and management of trapezius muscle‐related myofascial pain
Author(s) -
Townsley P.,
Ravenscroft A.,
Bedforth N.
Publication year - 2011
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06691.x
Subject(s) - medicine , accessory nerve , trapezius muscle , myofascial pain syndrome , nerve block , blockade , anesthesia , neck pain , electromyography , surgery , physical medicine and rehabilitation , alternative medicine , receptor , pathology
Summary We report the first description of ultrasound‐guided spinal accessory nerve blockade using single‐shot and subsequently continuous infusion (via a perineural catheter) local anaesthetic techniques, for the diagnosis and treatment of myofascial pain affecting the trapezius muscle. A 38‐year‐old man presented with a two‐year history of incapacitating left suprascapular pain after a fall onto his outstretched hand. The history and clinical examination was suggestive of myofascial pain affecting the trapezius muscle. This had been unresponsive to pharmacological therapy, physiotherapy or suprascapular nerve blockade. Following identification of the spinal accessory nerve in the posterior triangle of the neck, we performed ultrasound‐guided nerve blocks, first using a single injection of local anaesthetic and subsequently using a continuous infusion via a perineural catheter, to block the nerve and temporarily relieve the patient’s pain. We have demonstrated that the spinal accessory nerve is identifiable in the posterior triangle of the neck and can be blocked successfully using ultrasound guidance. This technique can aid the diagnosis and treatment of myofascial pain originating from the trapezius muscle.