Surgeon-Performed Peripheral Nerve Blocks for the Identification of Thoracic Outlet Syndrome

Abstract

Thoracic outlet syndrome (TOS) is a group of disorders caused by compression of neurovascular structures in the thoracic outlet, presenting with arm pain, paresthesia, and muscle weakness. Peripheral nerve blocks of the anterior scalene and pectoralis minor muscles are traditionally performed by radiologists and pain specialists for diagnosis. This study evaluates the efficacy of surgeon-performed nerve blocks in diagnosing and treating TOS. We conducted a retrospective chart review for patients receiving ultrasound-guided nerve blocks performed by a vascular surgeon from 2022 to 2023. Among 87 patients, 72.4% were diagnosed with neurogenic TOS, and surgical interventions were performed in 46 (52.9%) patients. Of these, 71.7% reported symptom improvement postoperatively. Ultrasound-guided peripheral nerve blocks performed by vascular surgeons offer an efficient way to work up neurogenic TOS and identify patients who may obtain prolonged symptomatic improvement following vascular surgery.