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Interscalene brachial plexus block

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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
#1
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
#2
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...
March 8, 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
#3
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...
March 2, 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
#4
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...
March 1, 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
#5
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...
February 19, 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
#6
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...
February 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28050801/low-dose-intravenous-dexamethasone-4-mg-and-10-mg-significantly-prolongs-the-analgesic-duration-of-single-shot-interscalene-block-after-arthroscopic-shoulder-surgery-a-prospective-randomized-placebo-controlled-study
#7
Frédéric Chalifoux, François Colin, Patrick St-Pierre, Nadia Godin, Véronique Brulotte
BACKGROUND: Although intravenous dexamethasone prolongs the analgesic duration of interscalene brachial plexus block, it is uncertain whether this effect can be observed using lower doses of dexamethasone. This study evaluated the impact of intravenous dexamethasone (4 mg and 10 mg) on the analgesic duration of single-shot interscalene block after arthroscopic shoulder surgery. We hypothesized that both doses would prolong the analgesic duration compared with placebo. METHODS: This was a prospective double-blind randomized placebo-controlled study in patients undergoing elective arthroscopic shoulder surgery under regional anesthesia with a single-shot interscalene block (0...
March 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28025374/effect-of-local-anesthetic-concentration-0-2-vs-0-1-ropivacaine-on-pulmonary-function-and-analgesia-after-ultrasound-guided-interscalene-brachial-plexus-block-a-randomized-controlled-study
#8
Andrew K Wong, Lauren Georgiades Keeney, Liting Chen, Rebekah Williams, Jiabin Liu, Nabil M Elkassabany
OBJECTIVE: This study aims to assess diaphragmatic excursion and measure pulmonary functions as measures of the degree to which the phrenic nerve is blocked after ISB with two different concentrations of ropivacaine: 0.2% and 0.1%. DESIGN: Randomized, double-blinded study. SETTING AND PATIENTS: Ambulatory surgical facility. SUBJECTS: Fifty patients undergoing shoulder arthroscopy for rotator cuff repair. METHODS: Patients were randomized to receive ultrasound-guided ISB with 20 mL of either 0...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28003697/isoflurane-versus-sevoflurane-with-interscalene-block-for-shoulder-arthroscopic-procedures-value-of-process-capability-indices-as-an-additional-tool-for-data-analysis
#9
Thrivikrama Padur Tantry, Harish Karanth, Sunil P Shenoy, Shreekantha V Ayya, Pramal K Shetty, Karunakara K Adappa
BACKGROUND AND AIMS: Hypotensive anaesthesia reduces intra-articular bleed and promotes visualisation during arthroscopy. The haemodynamic effects of inhalational agents isoflurane and sevoflurane were studied extensively, and both were found to reduce mean arterial pressures (MBP) to an equivalent magnitude. We investigated the relative ability of isoflurane vis-a-vis sevoflurane to maintain the target systolic blood pressure (SBP) in patients undergoing shoulder arthroscopic procedures...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27989283/prolonged-diaphragmatic-dysfunction-in-continuous-interscalene-brachial-plexus-block-is-it-clinically-relevant
#10
EDITORIAL
Audrey De Jong, Samir Jaber
No abstract text is available yet for this article.
December 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27941477/diaphragm-sparing-nerve-blocks-for-shoulder-surgery
#11
De Q H Tran, Maria Francisca Elgueta, Julian Aliste, Roderick J Finlayson
Shoulder surgery can result in significant postoperative pain. Interscalene brachial plexus blocks (ISBs) constitute the current criterion standard for analgesia but may be contraindicated in patients with pulmonary pathology due to the inherent risk of phrenic nerve block and symptomatic hemidiaphragmatic paralysis. Although ultrasound-guided ISB with small volumes (5 mL), dilute local anesthetic (LA) concentrations, and LA injection 4 mm lateral to the brachial plexus have been shown to reduce the risk of phrenic nerve block, no single intervention can decrease its incidence below 20%...
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27916737/suprascapular-block-associated-with-supraclavicular-block-an-alternative-to-isolated-interscalene-block-for-analgesia-in-shoulder-instability-surgery
#12
W Trabelsi, A Ben Gabsia, A Lebbi, W Sammoud, I Labbène, M Ferjani
BACKGROUND: Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. METHODS: Sixty ASA physical status I-II patients scheduled to undergo shoulder instability surgery were included...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27716229/particulate-steroid-betamethasone-added-to-ropivacaine-in-interscalene-brachial-plexus-block-for-arthroscopic-rotator-cuff-repair-improves-postoperative-analgesia
#13
Kunitaro Watanabe, Joho Tokumine, Tomoko Yorozu, Kumi Moriyama, Hideaki Sakamoto, Tetsuo Inoue
BACKGROUND: Dexamethasone added to local anesthetic for brachial plexus block improves postoperative pain after arthroscopic rotator cuff repair, as compared with the use of local anesthetic alone. Dexamethasone is present in non-particulate form in local anesthetic solution, while betamethasone is partially present in particulate form. The particulate betamethasone gradually decays and is expected to cause its longer-lasting effect. This study investigated the postoperative analgesic effect of betamethasone added to ropivacaine for brachial plexus block in patients who underwent arthroscopic rotator cuff repair...
October 4, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27716157/effects-of-a-fixed-low-dose-ropivacaine-with-different-volume-and-concentrations-on-interscalene-brachial-plexus-block-a-randomized-controlled-trial
#14
Wenwen Zhai, Xuedong Wang, Yulan Rong, Min Li, Hong Wang
BACKGROUND: Ultrasound guidance has reduced the amount of local anesthetics to achieve a successful block. Previous studies of the relationship between the volume or concentration of local anesthetics and the effects of the block were based on relatively high doses of local anesthetics. We tested the hypothesis that providing low dose of ropivacaine at three combinations of volumes and concentrations for ultrasound-guided interscalene brachial plexus block would produce different effects in the aspect of onset time, pain control and the incidence of side effects...
September 30, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27631270/a-prospective-randomized-and-controlled-study-of-interscalene-brachial-plexus-block-for-arthroscopic-shoulder-surgery-a-comparison-of-c5-and-conventional-approach-a-consort-compliant-article
#15
RANDOMIZED CONTROLLED TRIAL
Hyun-Jung Shin, Hyo-Seok Na, Ah-Young Oh, Jung-Won Hwang, Byung-Gun Kim, Hee-Pyoung Park, Young-Tae Jeon, Seong-Won Min, Jung-Hee Ryu
BACKGROUND: The shoulder area is mainly innervated with the C5 and C6 nerve roots, and interscalene brachial plexus block (ISB) is widely used for postoperative analgesia after shoulder surgery. However, it is associated with adverse effects, such as numbness and weakness in the blocked arm due to an unwanted block of the lower brachial plexus (C7-T1). We hypothesized that the C5 approach during ISB would provide postoperative analgesia while minimizing adverse events after arthroscopic shoulder surgery...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27575034/comparison-of-interscalene-brachial-plexus-block-performed-with-and-without-steroids
#16
RANDOMIZED CONTROLLED TRIAL
Brian G Webb, Peter I Sallay, Sherman D McMurray, Gary W Misamore
This prospective comparative clinical study was performed to evaluate the effect of triamcinolone when added to bupivacaine during brachial plexus blockade in patients undergoing shoulder surgery. Interscalene brachial plexus blocks were performed on 910 patients before shoulder surgery. Of the patients, 574 were randomly allocated to receive steroids added to the injected local anesthetic and 336 patients received local anesthetic without steroids. All patients were followed prospectively to evaluate the rate of successful anesthesia, duration of anesthesia, side effects of the block, adverse events, and persistent neurologic complications associated with interscalene brachial plexus block...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27560643/traction-injury-of-the-brachial-plexus-confused-with-nerve-injury-due-to-interscalene-brachial-block-a-case-report
#17
Francisco Ferrero-Manzanal, Raquel Lax-Pérez, Roberto López-Bernabé, José Ramiro Betancourt-Bastidas, Alvaro Iñiguez de Onzoño-Pérez
INTRODUCTION: Shoulder surgery is often performed with the patient in the so called "beach-chair position" with elevation of the upper part of the body. The anesthetic procedure can be general anesthesia and/or regional block, usually interscalenic brachial plexus block. We present a case of brachial plexus palsy with a possible mechanism of traction based on the electromyographic and clinical findings, although a possible contribution of nerve block cannot be excluded. PRESENTATION OF THE CASE: We present a case of a 62 year-old female, that suffered from shoulder fracture-dislocation...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27473162/phrenic-nerve-block-caused-by-interscalene-brachial-plexus-block-breathing-effects-of-different-sites-of-injection
#18
Lars Bergmann, Stefan Martini, Miriam Kesselmeier, Wolf Armbruster, Thomas Notheisen, Michael Adamzik, Rϋdiger Eichholz
BACKGROUND: Interscalene brachial plexus (ISB) block is often associated with phrenic nerve block and diaphragmatic paresis. The goal of our study was to test if the anterior or the posterior ultrasound guided approach of the ISB is associated with a lower incidence of phrenic nerve blocks and impaired lung function. METHODS: This was a prospective, randomized and single-blinded study of 84 patients scheduled for elective shoulder surgery who fullfilled the inclusion and exclusion critereria...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27413483/risk-of-encountering-dorsal-scapular-and-long-thoracic-nerves-during-ultrasound-guided-interscalene-brachial-plexus-block-with-nerve-stimulator
#19
Yeon Dong Kim, Jae Yong Yu, Junho Shim, Hyun Joo Heo, Hyungtae Kim
BACKGROUND: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach...
July 2016: Korean Journal of Pain
https://www.readbyqxmd.com/read/27329990/continuous-interscalene-brachial-plexus-nerve-block-prolongs-unilateral-diaphragmatic-dysfunction
#20
Philippe Cuvillon, Frederic Le Sache, Christophe Demattei, Lionel Lidzborski, Lana Zoric, Bruno Riou, Olivier Langeron, Mathieu Raux
BACKGROUND AND OBJECTIVES: Single interscalene blocks (ISB) impair pulmonary function (<24h). We hypothesized that continuous ISBs would prolong pulmonary dysfunction until h48 compared with a single ISB. We compared the time course of spirometric and diaphragmatic dysfunction following single or continuous ISBs. METHODS: We prospectively included consecutive adult patients scheduled to undergo shoulder surgery under standard general anaesthesia with single (n=30) or continuous (n=31) ISB...
December 2016: Anaesthesia, Critical Care & Pain Medicine
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