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Interscalene block

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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
#1
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...
January 3, 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
#2
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/28017161/ultrasound-guided-peripheral-nerve-blocks-in-anticoagulated-patients-case-series
#3
Luis Eduardo Silveira Martins, Leonardo Henrique Cunha Ferraro, Alexandre Takeda, Masashi Munechika, Maria Angela Tardelli
BACKGROUND AND OBJECTIVES: The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Moreover, peripheral blocks vary in depth, spreadability, and possibility of local compression...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28005096/liposomal-bupivacaine-vs-interscalene-nerve-block-for-pain-control-after-shoulder-arthroplasty-a-retrospective-cohort-analysis
#4
Casey V Hannan, Matthew J Albrecht, Steve A Petersen, Uma Srikumaran
The aim of this study was to compare liposomal bupivacaine and interscalene nerve block (ISNB) for analgesia after shoulder arthroplasty. We compared 37 patients who received liposomal bupivacaine vs 21 who received ISNB after shoulder arthroplasty by length of hospital stay (LOS), opioid consumption, and postoperative pain. Pain was the same in both groups for time intervals of 1 hour and 8 to 14 hours postoperatively. Compared with ISNB patients, liposomal bupivacaine patients reported less pain at 18 to 24 hours (P = ...
November 2016: American Journal of Orthopedics
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
#5
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
#6
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/27988164/effects-of-a-single-dose-interscalene-block-on-pain-and-stress-biomarkers-in-patients-undergoing-arthroscopic-rotator-cuff-repair-a-randomized-controlled-trial
#7
Xiao Ning Liu, Young-Min Noh, Cheol-Jung Yang, Jung Uk Kim, Mi Hwa Chung, Kyu Cheol Noh
PURPOSE: To compare the effects of a single-dose interscalene block and general anesthesia (SISB/GA) with the effects of GA only in the early postoperative period after arthroscopic rotator cuff repair by evaluating subjective pain visual analog scale scores and objective pain-related stress biomarkers. METHODS: Patients refractory to conservative treatment of the affected shoulder were enrolled in this prospective, randomized endpoint study. Patients diagnosed with a rotator cuff tear (1-4 cm) based on magnetic resonance imaging were included...
December 14, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27941477/diaphragm-sparing-nerve-blocks-for-shoulder-surgery
#8
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/27938934/medial-approach-of-ultrasound-guided-costoclavicular-plexus-block-and-its-effects-on-regional-perfussion
#9
D Nieuwveld, V Mojica, A E Herrera, J Pomés, A Prats, X Sala-Blanch
INTRODUCTION: Ultrasound-guided infraclavicular block in the costoclavicular space located between the clavicle and the first rib, reaches the secondary trunks when they are clustered together and lateral to the axillary artery. This block is most often performed through a lateral approach, the difficulty being finding the coracoid process an obstacle and guiding the needle towards the vessels and pleura. A medial approach, meaning from inside to outside, will avoid these structures. Traditionally the assessment of a successful block is through motor or sensitive responses but a sympathetic fibre block can also be evaluated measuring the changes in humeral artery blood flow, skin temperature and/or perfusion index...
December 8, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27916737/suprascapular-block-associated-with-supraclavicular-block-an-alternative-to-isolated-interscalene-block-for-analgesia-in-shoulder-instability-surgery
#10
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...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#11
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27861451/further-thoughts-regarding-the-value-of-interscalene-blocks
#12
Robert Altman, Jan Boublik, Arthur Atchabahian
No abstract text is available yet for this article.
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27856266/local-injection-of-liposomal-bupivacaine-combined-with-intravenous-dexamethasone-reduces-postoperative-pain-and-hospital-stay-after-shoulder-arthroplasty
#13
Howard D Routman, Logan R Israel, Molly A Moor, Andrew D Boltuch
BACKGROUND: Alternative techniques have been developed to address pain after shoulder arthroplasty and are well documented. We evaluated the effect of adding intraoperative liposomal bupivacaine and intravenous dexamethasone during shoulder arthroplasty. METHODS: We retrospectively reviewed 2 consecutive cohorts undergoing elective shoulder arthroplasty. The 24 patients in cohort 1 and the 31 patients in cohort 2 received perioperative multimodal management with preoperative and postoperative intravenous and oral narcotics, gabapentin, nonsteroidal anti-inflammatory drugs, acetaminophen, and single-injection interscalene block...
November 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27816092/editorial-commentary-is-it-time-for-surgeons-to-take-back-the-block-do-it-yourself-suprascapular-nerve-blocks-for-arthroscopic-rotator-cuff-repair
#14
EDITORIAL
Seth L Sherman
Surgeon administered intraoperative shoulder suprascapular nerve block appears to be a safe, effective, "low tech," and inexpensive alternative to a preoperative interscalene block performed by an anesthesia provider. Surgeons should thoughtfully weigh the pros and cons of this technique and consider "taking back the block."
November 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27771263/clinical-efficacy-of-hydrodistention-with-joint-manipulation-under-interscalene-block-compared-with-intra-articular-corticosteroid-injection-for-frozen-shoulder-a-prospective-randomized-controlled-study
#15
Sang Won Mun, Chang Hee Baek
BACKGROUND: Hydrodistention is known to be an effective method of treatment for frozen shoulder. However, hydrodistention is accompanied by severe pain during the procedure. An interscalene block may relieve the severe pain associated with the procedure of hydrodistention. This study compared the clinical efficacy of hydrodistention with joint manipulation under an interscalene block with that of intra-articular corticosteroid injection. METHODS: This prospective randomized controlled study included 121 patients presenting with frozen shoulder...
December 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27737296/incidence-of-and-risk-factors-for-symptomatic-venous-thromboembolism-after-shoulder-arthroplasty
#16
Robert Z Tashjian, Daniel T Lilly, Aaron M Isaacson, Cory E Georgopoulos, Stephen P Bettwieser, Robert T Burks, Patrick E Greis, Angela P Presson, Erin K Granger, Yue Zhang
Reported rates of venous thromboembolism (VTE) after shoulder arthroplasty (SA) range from 0.2% to 13%. Few studies have evaluated the incidence of VTE in a large patient population from a single institution. We conducted a study to determine the incidence of VTE (deep venous thrombosis [DVT] and pulmonary embolism [PE]) in a large series of SAs. Cases of SAs performed at our institution between January 1999 and May 2012 were retrospectively reviewed for development of symptomatic VTE within the first 90 days after surgery...
September 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27729319/pain-management-after-outpatient-shoulder-arthroscopy-a-systematic-review-of-randomized-controlled-trials
#17
William J Warrender, Usman Ali M Syed, Sommer Hammoud, William Emper, Michael G Ciccotti, Joseph A Abboud, Kevin B Freedman
BACKGROUND: Effective postoperative pain management after shoulder arthroscopy is a critical component to recovery, rehabilitation, and patient satisfaction. PURPOSE: This systematic review provides a comprehensive overview of level 1 and level 2 evidence regarding postoperative pain management for outpatient arthroscopic shoulder surgery. STUDY DESIGN: Systematic review. METHODS: We performed a systematic review of the various modalities reported in the literature for postoperative pain control after outpatient shoulder arthroscopy and analyzed their outcomes...
October 11, 2016: American Journal of Sports Medicine
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
#18
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
#19
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/27687453/delayed-onset-and-long-lasting-hemidiaphragmatic-paralysis-and-cranial-nerve-deficit-after-interscalene-nerve-block-for-rotator-cuff-repair-in-beach-chair-position
#20
Chukwudi O Chiaghana, Caleb A Awoniyi
Hemidiaphragmatic paralysis is the most common adverse effect associated with interscalene block. In most cases, it resolves with the resolution of nerve blockade with only an estimated incidence of 0.048% persisting for longer duration. Occasionally, interscalene block is also associated with recurrent laryngeal nerve block and seldom with cranial nerve paresis. We present a case of delayed onset and prolonged hemidiaphragmatic paralysis that was associated with 3 cranial nerve deficits after interscalene nerve block for shoulder surgery performed under general anesthesia in the beach chair position...
November 2016: Journal of Clinical Anesthesia
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