The cervical paravertebral stop introduces the needle between the levator scapulae and trapezius muscles and directs the catheter anteriorly to lie over the brachial plexus. Under ongoing in plane ultrasound assistance, the needle was directed anteriorly toward the brachial plexus, cross Utilizing a posterior approach natural product library towards the brachial plexus may possibly reduce the incidence of these issues. In the blind method previously described,12 the needle is advanced within an anterior direction until it contacts the transverse process of the cervical vertebra, then walked laterally along the transverse process, and advanced more anteriorly until the brachial plexus is located. But, the closeness of the hook to the neuraxis has resulted in difficulties linked to the approach including epidural,intrathecal,and intracord injection,leading some practitioners to question the acceptability of the risk-benefit ratio. Supporters of the posterior approach maintain that complications might be eliminated with anatomic familiarity, right equipment, and improvements in method. We describe an ultrasound guided interscalene perineural catheter technique that maintains the multiple benefits of the posterior approach, by utilizing Chromoblastomycosis realtime imaging to properly place the needle in to the interscalene groove, along with a stimulating perineural catheter to pick the distribution of anesthesia. A 55-year old man presented for total shoulder arthroplasty. The patient preferred perineural catheter placement for postoperative analgesia, and the posterior method of the brachial plexus was chosen in order to avoid the external jugular vein and expected clean surgical field from the doctors request. Of notice, the University of California San Diego Institutional Review Board Cathepsin Inhibitor 1 specifically doesn’t require assessment of medical case reports. Normal American Society of Anesthesiologists screens and oxygen via facemask were used, the individual was positioned right lateral decubitus with the top of the bed somewhat raised, and the skin was prepared with anti-septic solution just before application of the sterile drape. Intravenous midazolam and fentanyl were titrated for patient comfort. Utilizing a 6 to 13 MHz linear ultrasound probe, the brachial plexus trunks were determined between the left anterior and middle scalene muscles at the cephalad caudad amount of the cricothyroid membrane. At the junction of the levator scapulae and trapezius muscles, 10 percent lidocaine was injected to anesthetize the course, and skin into the middle scalene muscle under ultrasound guidance. With the bevel directed caudad and lateral, an 8. 89 cm, 17 gauge, protected Tuohy idea needle was inserted through the lidocaine skin wheal. The needle was connected to a nerve stimulator initially set at 1.