While we welcome research into regional anesthesia in order to improve the quality of our medical provision, the study by Abdallah et al. demonstrates highly relevant problems in research in this area. First, the authors describe the interscalene block as one that poses dangers to certain populations. This may be true for a minority of patients such as those with severe respiratory impairment, but the vast majority of patients are not restricted by any ensuing respiratory compromise. Studies of healthy patients demonstrate that the phrenic nerve palsy is of no clinical relevance. Given that 2.5 yr in three hospitals were required to obtain the 136 patients in this study, there does not appear to be a large group of patients likely to benefit from a new block.

It has to be realized that regional anesthesia...

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