Lipophilicity of drugs, including local anesthetics, and its association with lipid emulsion resuscitation
Susanne Κ. Wiedmer, Ju‐Tae Sohn
Abstract
block provides an additional block of the axillary nerve, suggesting that for the sub-omohyoid approach, the local anesthetic may reach at least the superior or intermediate trunk or the posterior division of the brachial plexus, which confirms the results reported by Siegenthaler et al. [2].Concerns regarding the novelty of the DiSC block are disconcerting.The DiSC block is a novel, potentially safer and simpler anterior approach that involves a diagonal view of the SSC through which the SSN travels [1].The approach proposed by Tran et al.[5] cannot be performed using an anterior approach because the clavicle conflicts with the ultrasound beam, preventing correct visualization of the SSC during the puncture; thus, the needle is inserted at a posterior entry point in the anterior medial direction using ultrasound visualization that is completely different from that with the DiSC block.To date, the sub-omohyoid SSN block has either been referred to as an anterior or supraclavicular SSN block.Given the introduction of this novel anterior approach, the term "anterior SSN block" cannot be used as a synonym for the sub-omohyoid SSN.Although anterior SSN block approaches have clear advantages, the sub-omohyoid SSN block is a less selective "anterior SSN block" than the DiSC block [3,4] and may be riskier.Therefore, although the sub-omohyoid SSN block may be the first option in most patients, it must be avoided in highrisk respiratory patients [3].In conclusion the diagonal suprascapular block is a simple, more selective in some scenarios and a safer anterior SSN block.