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Interscalene block

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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
#1
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
#2
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/28375899/think-again-about-that-block-commentary-on-an-article-by-surena-namdari-md-msc-et-al-randomized-controlled-trial-of-interscalene-block-compared-with-injectable-liposomal-bupivacaine-in-shoulder-arthroplasty
#3
https://www.readbyqxmd.com/read/28375887/randomized-controlled-trial-of-interscalene-block-compared-with-injectable-liposomal-bupivacaine-in-shoulder-arthroplasty
#4
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
#5
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/28367287/effect-of-an-epinephrine-mixture-for-interscalene-block-on-hemodynamic-changes-after-the-beach-chair-position-under-general-anesthesia-a-retrospective-study
#6
Bum-June Kim, Chae-Seong Lim, Boo-Hwi Hong, Ji-Yong Lee, Sun-Yeul Lee, Jung-Un Lee, Yoon-Hee Kim, Won-Hyung Lee, Seok-Hwa Yoon
BACKGROUND: The beach chair position (BCP) can cause significant hypotension. Epinephrine is used to prolong the duration of local anesthetics; it is also absorbed into blood and can exert systemic effects. This study determined the effects of epinephrine mixed with ropivacaine for an interscalene block (ISB) on hemodynamic changes related to BCP. METHODS: Patient data collected from March 2013 to August 2014 were used retrospectively. We divided the patients into three groups: 1) ISB only, 2) I+G (general anesthesia after ISB without epinephrine), and 3) I+E+G (general anesthesia after ISB with epinephrine)...
April 2017: Korean Journal of Anesthesiology
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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/28207648/a-comparison-of-combined-suprascapular-and-axillary-nerve-blocks-to-interscalene-block-interpret-with-caution
#14
Philippe Marty, Olivier Rontes, Alain Delbos
No abstract text is available yet for this article.
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28164268/a-comparison-of-ultrasound-guided-interscalene-and-supraclavicular-blocks-for-post-operative-analgesia-after-shoulder-surgery
#15
RANDOMIZED CONTROLLED TRIAL
B G Kim, J U Han, J H Song, C Yang, B W Lee, J S Baek
BACKGROUND: In contrast to interscalene block, there was little information regarding the analgesic efficacy of supraclavicular block for shoulder surgery. This study aimed to compare the analgesic efficacy and side effects of interscalene and supraclavicular blocks for shoulder surgery. METHODS: Patients scheduled for shoulder surgery were assigned to receive either ultrasound-guided interscalene (n = 25) or supraclavicular block (n = 24) with 20 ml of 0.375% ropivacaine...
April 2017: Acta Anaesthesiologica Scandinavica
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
#16
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
https://www.readbyqxmd.com/read/28151818/the-effect-of-fixation-technique-on-continuous-interscalene-nerve-block-catheter-success-a-randomized-double-blind-trial
#17
David B Auyong, David Asher Cantor, Cynthia Green, Neil A Hanson
BACKGROUND: Continuous peripheral nerve blocks offer advantages over single-injection blocks, including extended analgesia and reduction in opioid consumption. These benefits require that the perineural catheter remain intact for the duration of the planned local anesthetic infusion. Mechanical displacement of catheters, leaking, and consequent failure are known complications. The aim of this study was to evaluate continuous perineural catheter tip-to-nerve apposition in vivo over 48 hours comparing 2 different simple fixation strategies...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28116968/comparison-of-continuous-interscalene-block-and-subacromial-infusion-of-local-anesthetic-for-postoperative-analgesia-after-open-shoulder-surgery
#18
Semih Baskan, Deniz Cankaya, Hidayet Unal, Burak Yoldas, Vildan Taspinar, Alper Deveci, Yalcin Tabak, Mustafa Baydar
PURPOSE: This study compared the efficacy of continuous interscalene block (CISB) and subacromial infusion of local anesthetic (CSIA) for postoperative analgesia after open shoulder surgery. METHODS: This randomized, prospective, double-blinded, single-center study included 40 adult patients undergoing open shoulder surgery. All patients received a standardized general anesthetic. The patients were separated into group CISB and group CSIA. A loading dose of 40 mL 0...
January 2017: Journal of Orthopaedic Surgery
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
#19
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
#20
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
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