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Interscalene block

Robert T 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
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
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
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
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
Katherine H Dobie, Yaping Shi, Matthew S Shotwell, Warren S Sandberg
STUDY OBJECTIVE: Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. DESIGN: Prospective case series. SETTING: Vanderbilt Bone and Joint Surgery Center. PATIENTS: Patients undergoing shoulder arthroscopy at an ambulatory surgery center...
November 2016: Journal of Clinical Anesthesia
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)
E Velázquez-Delgado, S P Gaspar-Carrillo, A A Peña-Riveron, G E Mejía-Terrazas
INTRODUCTION: Dexmedetomidine prolongs sensory block of ropivacaine. Our objective was to study whether this extension would produce better postoperative pain control compared to that produced by clonidine in patients undergoing arthroscopic shoulder. MATERIALS AND METHODS: Study comparative, longitudinal, controlled, randomized into 3 groups. Control group I: ropivacaine 0.75% clonidine group II: 0.75% ropivacaine plus clonidine 1mg/kg group iiidexmedetomidine: 0...
September 9, 2016: Revista Española de Anestesiología y Reanimación
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...
August 30, 2016: Orthopedics
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
Rodney A Gabriel, Alexander Nagrebetsky, Alan D Kaye, Richard P Dutton, Richard D Urman
The interscalene block (ISB) is a common adjunct to general anesthesia for total shoulder arthroplasty (TSA). The aim of the study was to report the current national demographics of the patients who are receiving ISB for TSAs. We performed a retrospective analysis of data from the National Anesthesia Clinical Outcomes Registry from 2010 to 2015. Of 28,810 cases, 42.1% received an ISB. Only 0.83% of cases received regional anesthesia as the primary anesthetic. From 2010 to 2014, there has been an increase in ISB utilization for this surgery (odds ratio, 1...
September 2016: Anesthesia and Analgesia
M Heron, R Dattani, R Smith
No abstract text is available yet for this article.
August 2, 2016: British Journal of Hospital Medicine
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
Murtaza Kaya, Sami Eksert, Sinan Akay, Ali Kantemir, Kenan Keklikci
No abstract text is available yet for this article.
July 1, 2016: American Journal of Emergency Medicine
Kelechi R Okoroha, Jonathan R Lynch, Robert A Keller, John Korona, Chad Amato, Brian Rill, Patricia A Kolowich, Stephanie J Muh
HYPOTHESIS: Our hypothesis was that in patients undergoing shoulder arthroplasty, a prospective randomized trial would find no significant differences in average daily pain scores of those treated with interscalene nerve block (INB) vs. local liposomal bupivacaine (LB). METHODS: Sixty patients undergoing primary shoulder arthroplasty were assessed for eligibility. Study arms included either intraoperative local infiltration of LB (20 mL bupivacaine/20 mL saline) or preoperative INB, with a primary outcome of postoperative average daily visual analog scale scores for 4 days...
November 2016: Journal of Shoulder and Elbow Surgery
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
Shalini Dhir, Rakesh V Sondekoppam, Ranjita Sharma, Sugantha Ganapathy, George S Athwal
BACKGROUND AND OBJECTIVES: The primary objective of this study was to compare the analgesic efficacy of combined suprascapular and axillary nerve block (SSAX) with interscalene block (ISB) after arthroscopic shoulder surgery. Our hypothesis was that ultrasound-guided SSAX would provide postoperative analgesia equivalent to ISB. METHODS: Sixty adult patients undergoing arthroscopic shoulder surgery received either SSAX or ISB prior to general anesthesia, in a randomized fashion...
September 2016: Regional Anesthesia and Pain Medicine
M A Corvetto, J Carmona, M I Vásquez, C Salgueiro, J Crostón, R Sosa, V Folle, F R Altermatt
OBJECTIVE: A survey was conducted in order to obtain a profile of the practice of regional anesthesia in South America, and determine the limitations of its use. METHODS: After institutional ethics committee approval, a link to an online questionnaire was sent by e-mail to anaesthesiologists in Argentina, Bolivia, Chile, Colombia, Panamá, Paraguay, Perú, and Uruguay. The questionnaire was processed anonymously. RESULTS: A total of 1,260 completed questionnaires were received...
July 1, 2016: Revista Española de Anestesiología y Reanimación
R Fuzier, S Lammens, L Becuwe, B Bataille, J C Sleth, D Jochum, E Boselli
A cross-sectional survey study on French practice in ultrasound-guided regional anesthesia was carried out. A questionnaire (demographic data, assessment of the likely benefits of ultrasonography, and its use in daily practice: blocks and hygiene) was emailed to all members of the French-speaking association of anesthesiologists involved in regional anesthesia. The questionnaire was filled out and returned by 634 experienced anesthesiologists. An ultrasound machine was available in 94% of cases. Ultrasound-guided regional anesthesia has become the gold standard technique for three-quarters of responders...
2016: Acta Anaesthesiologica Belgica
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...
June 18, 2016: Anaesthesia, Critical Care & Pain Medicine
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