Interscalene brachial plexus block

The sternal notch, sternal and clavicular heads of sternocleidomastoid muscle, and clavicle are identified and marked. The groove between the anterior and middle scalene muscles is palpated. For ultrasound-guided block, the ultrasound probe is placed as shown by the rectangle in this graphic. For either ultrasound-guided block or nerve stimulator-guided block, the needle insertion site is approximated by the red dot. See the text for description of block technique.