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Phrenic Sparing Interscalene Block  The PSIB Study


Updated October 7, 2006

A New Type of Technical Study - To Identify and Fix the Problems of Regional Nerve Blocks

Welcome to the Phrenic Sparing Interscalene Block (PSIB) page.  The PSIB study is an “Open Source” study to identify the incidence of partial or complete block of the phrenic and resultant hemidiaphragm paralysis or paresis concurrent with interscalene or supraclavicular brachial plexus block using different techniques. (was that a run-on sentence or what?)   Incidence of concurrent phrenic block was commonly identified in the past as 100%, but that was then (with nerve stimulators and large volumes) and this is now (with ultrasound needle placement and lower volumes) so it’s time to not only look at the subject again, but to expect to find a way to reduce it to a minimum.

This project was conceived as a collaboration of Dr. Andre Ceccoli of USinRA and Neuraxiom, and will be carried out through the efforts of us and viewers like you. 

We invite to you look at the data we’ve collected, re-arrange it to see if it makes more sense to you, draw out reports from it, consider it. discuss it with colleagues and on our forum.  You can interpret the data as well as anyone.  But that’s just the starting point; we encourage you to contribute your own cases to the database. 

Your cases are as good as ours, so feel free to sign in and enter a small set of information from your interscalene and supraclavicular blocks.  We ask only that you let us verify that you’re not a drive-by vandal by registering in our forum*  Once you’ve registered in the forum you may enter your data.  Please remember you username and password so that you can enter more cases later.

Data entry of cases will be easy and quick.  After registration We are looking for round numbers here, we’ve all seen study data that reported un-necessary details and we’re not going there with this.  We’re asking for patient weight instead of BMI because you know what weight means in general for adults as well as anyone. Patient weight can be your best guess, you don’t have to confirm diaphragmatic impairment with M-Mode ultrasound or fluoroscopy, if you clinically see impairment you can enter it that way.  AND we want data from blocks done using all types of techniques.  We WANT nerve stimulator cases. We WANT location by parasthesia if that’s the way you do it.  If you use a combined technique with ultrasound and a nerve stimulator, BRING IT ON.  When the data is all there, YOU will see what it means.  It will be Self-Evident.

The block following this article contains links to the Data Entry and Data Viewing pages.  Click on those links to lend a hand on this project.

Thanks for reading this and please come back and see how this project goes.

Thanks, Jack

*- Registration requires only a username (not neccessarily your real name), a password and a valid email address. Click here to register in our forum and be ready to enter data.

PSIB Database Pages

1- Add Your Case Data to the Study Database

2- View Database / Listing and Summary

3 - Create Reports and Query the Database - Not Yet Implemented

    Phrenic Block - How Does it Happen? 

    Click on the picture to the right to see an animation of one way we have observed the phrenic nerve being included in the interscalene block.        

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