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Interscalene brachial plexus block

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https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#1
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28712103/randomised-controlled-trial-of-analgesic-effectiveness-of-three-different-techniques-of-single-shot-interscalene-brachial-plexus-block-using-20-ml-of-0-5-ropivacaine-for-shoulder-arthroscopy
#2
Michał Jan Stasiowski, Michał Kolny, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Bartłomiej Możdżyński
Background Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation. METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I-III status scheduled for elective shoulder arthroscopy ...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28665875/neuralgic-amyotrophy-attributed-incorrectly-to-block-related-injury-understanding-errors-in-clinical-reasoning
#3
Joseph M Neal, Susan S Porter, Barry P Wilson
OBJECTIVE: We report a case of misdiagnosed neuralgic amyotrophy (brachial plexus neuritis, Parsonage-Turner syndrome). Our primary objective is to review the scientific basis for errors in clinical reasoning. CASE REPORT: We herein report a patient in whom signs and symptoms compatible with neuralgic amyotrophy presented after shoulder surgery. The patient's brachial plexopathy was attributed incorrectly as a complication of interscalene brachial plexus block. The true diagnosis was made only after the patient developed neuralgic amyotrophy in the contralateral upper extremity after a subsequent shoulder surgery on that side, this time without a brachial plexus block...
June 29, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28651954/case-report-ultrasound-guided-infraclavicular-brachial-plexus-block-for-a-case-with-posterior-elbow-dislocation
#4
Sinan Akay, Sami Eksert, Murtaza Kaya, Kenan Keklikci, Ali Kantemir
BACKGROUND: The interest in regional anesthesia procedures for the management of upper-extremity emergencies has increased. Toward that end, supraclavicular, interscalene, or infraclavicular approaches, with or without ultrasound guidance, are used for brachial plexus nerve blocks. Although many studies have reported on the use of ultrasound-guided supraclavicular and interscalene brachial plexus blocks for upper-extremity dislocations, very few studies have reported on the use of ultrasound-guided infraclavicular brachial plexus blocks...
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28609340/effect-of-interscalene-brachial-plexus-block-on-the-pulmonary-function-of-obese-patients-a-prospective-observational-cohort-study
#5
M Stephen Melton, Hanni E Monroe, Wenjing Qi, Stephanie L Lewis, Karen C Nielsen, Stephen M Klein
BACKGROUND: The effect of interscalene block (ISB) on pulmonary function of obese participants has not been investigated. The goal of this study is to assess the association of obesity (body mass index [BMI] >29 kg/m vs BMI <25 kg/m) and change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) after ISB in participants undergoing outpatient shoulder surgery. METHODS: This prospective, observational cohort study compared obese (BMI >29 kg/m) and normal-weight (BMI <25 kg/m) groups undergoing ISB for ambulatory shoulder surgery, on preblock and postblock FVC and FEV1, at 30 minutes postblock and in the postanesthesia care unit (PACU)...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598917/improving-performance-by-monitoring-the-success-rate-of-peripheral-nerve-blocks
#6
Sietske M K Bakker, Rudolf Stienstra
In our hospital, we introduced a system to measure the collective and individual efficacy of brachial plexus and popliteal nerve blocks with the objective to create transparency as an instrument for monitoring and improvement. Initially, individual results were anonymous, but after 1 year anonymity was lifted within the team of anesthesiologists and results are now discussed quarterly. Collective performance of interscalene, supraclavicular, and popliteal blocks improved significantly over time. Sharing and discussing collective and individual performance has resulted in critical self-appraisal and increased willingness to learn from each other and strengthened the team's ambition for further improvement...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28542052/continuous-interscalene-block-for-postoperative-analgesia-and-shoulder-immobilization-after-pectoralis-major-tendon-reinsertion-a-case-report
#7
John J Finneran, Brian M Ilfeld, Jacklynn F Sztain
We present the case of a 38-year-old man undergoing surgical repair of his pectoralis major tendon. An interscalene catheter was placed between the middle and lower trunks of the brachial plexus. Postoperatively, ropivacaine 0.2% was infused through postoperative day. The patient had excellent pain control requiring minimal opioid analgesics. A catheter between the middle and lower trunks of the brachial plexus provided excellent postoperative analgesia after pectoralis major tendon reinsertion. Additionally, the block likely protected the surgical repair during emergence from anesthesia and in the early postoperative period by providing a motor block of the pectoralis major muscle...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28460809/ultrasound-guided-interscalene-nerve-block-vs-procedural-sedation-by-propofol-and-fentanyl-for-anterior-shoulder-dislocations
#8
Esmaeil Raeyat Doost, Mohammad Mehdi Heiran, Mitra Movahedi, Amirhossein Mirafzal
BACKGROUND: Few studies were performed to compare ultrasound guided brachial plexus block with procedural sedation for reduction of shoulder dislocations in the Emergency Department (ED). This study was done to provide further evidence regarding this comparison. METHODS: This was a randomized clinical trial performed on patients presenting with anterior shoulder dislocations to the emergency department of an academic level 2 trauma center. Exclusion criteria were any contraindications to the drugs used, any patient which may not be potentially assigned into both groups because of an underlying medical condition, presence of neurovascular compromise related to the dislocation, presence of concomitant fractures, and patient refusal to participate in the study...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28403412/reduced-hemidiaphragmatic-paresis-with-extrafascial-compared-with-conventional-intrafascial-tip-placement-for-continuous-interscalene-brachial-plexus-block-a-randomized-controlled-double-blind-trial
#9
E Albrecht, I Bathory, N Fournier, A Jacot-Guillarmod, A Farron, R Brull
Background.: The incidence of hemidiaphragmatic paresis with continuous interscalene brachial plexus block (CISB) can approach 100%. We tested the hypothesis that extrafascial placement of the catheter tip reduces the rate of hemidiaphragmatic paresis compared with intrafascial tip placement for CISB while providing effective analgesia. Methods.: Seventy patients undergoing elective major shoulder surgery under general anaesthesia were randomized to receive an ultrasound-guided CISB plexus block for analgesia with the catheter tip placed either within (intrafascial group) or immediately outside (extrafascial group) the brachial plexus sheath midway between the levels of C5 and C6...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#10
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28375887/randomized-controlled-trial-of-interscalene-block-compared-with-injectable-liposomal-bupivacaine-in-shoulder-arthroplasty
#11
RANDOMIZED CONTROLLED TRIAL
Surena Namdari, Thema Nicholson, Joseph Abboud, Mark Lazarus, Dean Steinberg, Gerald Williams
BACKGROUND: Shortcomings of interscalene brachial plexus blockade include technical failure and rebound pain. Bupivacaine liposome injectable suspension, a sustained release preparation, is used for surgical-site administration. The purpose of this study was to evaluate these 2 postoperative pain management strategies in patients undergoing shoulder arthroplasty. METHODS: In a non-blinded, randomized controlled trial of participants undergoing primary shoulder arthroplasty, patients were randomized to interscalene brachial plexus blockade or intraoperative soft-tissue infiltration of bupivacaine liposome injectable suspension...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28372653/dexamethasone-as-a-ropivacaine-adjuvant-for-ultrasound-guided-interscalene-brachial-plexus-block-a-randomized-double-blinded-clinical-trial
#12
Thiago Mamôru Sakae, Patricia Marchioro, Fabiana Schuelter-Trevisol, Daisson José Trevisol
STUDY OBJECTIVE: The purpose of this study was to evaluate the effect of intravenous or perineural dexamethasone added to ropivacaine on the duration of ultrasound-guided interscalene brachial plexus blocks (BPB). DESIGN: Randomized clinical trial. SETTING, PATIENTS AND INTERVENTIONS: Sixty ASA physical status I-II patients with elective shoulder arthroscopic surgeries under interscalene brachial plexus blocks were randomly allocated to receive 20ml of 0...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28362032/randomized-comparative-study-of-the-effectiveness-of-three-different-techniques-of-interscalene-brachial-plexus-block-using-0-5-ropivacaine-for-shoulder-arthroscopy
#13
RANDOMIZED CONTROLLED TRIAL
Michał Kolny, Michał J Stasiowski, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Aleksandra Pluta, Przemysław Jałowiecki, Tomasz Byrczek
BACKGROUND: Interscalene brachial plexus block is an effective regional anesthesia technique for shoulder surgeries. The superiority of the popular ultrasound-guided blocks over peripheral nerve stimulator-confirmed blocks remains unclear. In this study the efficacy of these different block techniques was compared. METHODS: This prospective, randomized, clinical study included 109 patients (ASA grades I-III) who receive 20 mL 0.5% ropivacaine with ultrasound-guided blocks (U group), peripheral nerve stimulator-confirmed blocks (N group), or ultrasound-guided and peripheral nerve stimulator-confirmed blocks (dual guidance; NU group) for elective shoulder arthroscopy...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28344948/the-effect-of-combining-axillary-brachial-plexus-block-with-interscalene-or-supraclavicular-block-for-upper-limb-surgeries-using-neurostimulation-technique
#14
H O Idehen, C A Imarengiaye
BACKGROUND: The different approaches to the brachial plexus have clinical implications and all these approaches have clinical limitations. Combining different approaches helps to reduce these limitations. Can a combination of two different methods of brachial plexus block give a better anaesthetic outcome? AIM: To compare the effect of combining axillary plexus block with interscalene as opposed to axillary plexus block with supraclavicular blocks. DESIGN OF STUDY: Prospective observational study...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28298772/effect-of-dexmedetomidine-as-an-adjuvant-to-0-75-ropivacaine-in-interscalene-brachial-plexus-block-using-nerve-stimulator-a-prospective-randomized-double-blind-study
#15
H D Rashmi, H K Komala
BACKGROUND: Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#16
David B Auyong, Stanley C Yuan, Daniel S Choi, Joshuel A Pahang, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: Continuous brachial plexus blocks at the interscalene level are associated with known diaphragm dysfunction from phrenic nerve paresis. More distal blocks along the brachial plexus may provide postsurgical analgesia while potentially having less effect on diaphragm function. Continuous interscalene, continuous supraclavicular, and continuous suprascapular nerve blocks were evaluated for respiratory function and analgesia after total shoulder arthroplasty. METHODS: After ethics board approval, subjects presenting for total shoulder arthroplasty were planned for randomization in a 1:1:1 ratio of a continuous interscalene, supraclavicular, or suprascapular block...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28257388/anterior-suprascapular-nerve-block-versus-interscalene-brachial-plexus-block-for-shoulder-surgery-in-the-outpatient-setting-a-randomized-controlled-patient-and-assessor-blinded-trial
#17
Martin Wiegel, Bernhard Moriggl, Peter Schwarzkopf, David Petroff, Andreas W Reske
BACKGROUND AND OBJECTIVES: The interscalene brachial plexus block (ISB), a potent option to control pain after shoulder surgery, has notable adverse effects. The anterior suprascapular nerve block (SSNB) might provide comparable analgesia and cause less grip-strength impairment. These characteristics were studied in this randomized controlled patient- and assessor-blinded trial. METHODS: Outpatients were randomized to single-shot ultrasound-guided SSNB (10 mL ropivacaine 1%) or ISB (20 mL ropivacaine 0...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28252542/regional-anesthesia-with-noninvasive-ventilation-for-shoulder-surgery-in-a-patient-with-severe-chronic-obstructive-pulmonary-disease-a-case-report
#18
Fabrice Ferré, Nina Cugnin, Charlotte Martin, Philippe Marty, Nicolas Bonnevialle, Matt Kurrek, Vincent Minville
Interscalene block (ISB) impairs ipsilateral lung function and generally is not used for patients with respiratory insufficiency. We present a 49-year-old man with chronic obstructive pulmonary disease scheduled for shoulder surgery. He was given a regional technique with an ISB (short-acting local anesthetic to minimize duration of diaphragmatic dysfunction) and suprascapular and axillary nerves blocks (long-acting local anesthetic). He was supported with noninvasive ventilation during the time of hemidiaphragmatic paralysis as documented by serial ultrasound examination...
May 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28215043/is-the-change-of-percutaneous-oxygen-pressure-available-to-judge-the-effects-of-brachial-plexus-block
#19
Tomoki Nishiyama
BACKGROUND: To know the objective methods of the effects of the brachial plexus block, we studied the changes in percutaneous oxygen pressure (tcPO₂) with the hypothesis that tcPO₂ increases significantly on the blocked arm in comparison with the non-blocked arm, a phenomenon which is connected with vasodilation following the brachial plexus block. METHODS: Fifteen patients scheduled for upper extremity surgery, aged 20 to 70 years, with ASA physical status I or II were included...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28157791/addition-of-liposome-bupivacaine-to-bupivacaine-hcl-versus-bupivacaine-hcl-alone-for-interscalene-brachial-plexus-block-in-patients-having-major-shoulder-surgery
#20
Catherine Vandepitte, Max Kuroda, Richard Witvrouw, Ludwig Anne, Johan Bellemans, Kristoff Corten, Pascal Vanelderen, Dieter Mesotten, Ine Leunen, Micheline Heylen, Sam Van Boxstael, Monika Golebiewski, Marc Van de Velde, Nebojsa Nick Knezevic, Admir Hadzic
BACKGROUND AND OBJECTIVES: We examined whether liposome bupivacaine (Exparel) given in the interscalene brachial plexus block lowers pain in the setting of multimodal postoperative pain management for major shoulder surgery. METHODS: Fifty-two adult patients were randomized to receive either 5 mL of 0.25% bupivacaine HCl immediately followed by 10 mL of liposome bupivacaine 133 mg (n = 26) or 15 mL of 0.25% standard bupivacaine alone (n = 26) in interscalene brachial plexus block...
May 2017: Regional Anesthesia and Pain Medicine
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