Practical Atlas of Ultrasound for Anesthesia in Chronic Pain
Document Type
Book Chapter
Publication Date
4-3-2025
Publication Title
Practical Atlas of Ultrasound for Anesthesia in Chronic Pain
Abstract
Thoracic outlet syndrome (TOS) is a complex neurovascular disorder affecting any of the three anatomical compartments: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space [1]. Compression of the nerves, veins, and arteries in the thoracic outlet produces neurosensory and pain symptoms affecting the neck, upper chest, shoulder, arm, and hand [2]. Subcategories of TOS include neurogenic TOS (NTOS), arterial TOS (ATOS), and venous TOS (VTOS), with nearly 90% of all TOS cases consisting of neurologic origin [1]. Accurate diagnosis of TOS has proven to be difficult due to its complex etiology, as well as there being no existing definitive diagnostic test [1, 2]. Current advances in diagnostic methods include provocative injections using local anesthetic, which test for positive pain relief [2]. Treatment for NTOS ranges from conservative approaches, such as physical therapy, to more invasive approaches. Invasive treatment consists of injections of local anesthetic or botulinum toxin type A (BTX-A) prior to/in conjunction with surgery [1, 2]. Presently, scalene and pectoralis injections for NTOS may yield positive temporary relief and serve as a minimally invasive treatment compared to decompressive surgery [1, 2].
First Page
37
Last Page
40
Chapter Title
Chapter 8 - Scalene and Pectoralis Injections for Thoracic Outlet Syndrome
ISBN
[9781040258385, 9781032625904]
Recommended Citation
Broussard, B.; Flores, B.; Hsu, Eric; Weinberg, A. D.; and Eng, Matthew R., "Practical Atlas of Ultrasound for Anesthesia in Chronic Pain" (2025). School of Medicine Faculty Publications. 3699.
https://digitalscholar.lsuhsc.edu/som_facpubs/3699
10.1201/9781032625911-8