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Interscalene catheter

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)
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
Matthew Careskey, Ramana Naidu
Reverse open shoulder arthroplasty requires a comprehensive analgesic plan involving regional anesthesia. The commonly performed interscalene brachial plexus blockade confers a high likelihood of diaphragmatic paralysis via phrenic nerve palsy, making this option riskier in patients with limited pulmonary reserve. Continuous blockade of the suprascapular nerve, a more distal branch of the C5 and C6 nerve roots, may be a viable alternative. We report a successful case of the use of a suprascapular nerve block with continuous programmed intermittent bolus perineural analgesia in a patient with severe chronic obstructive pulmonary disease who underwent reverse open shoulder arthroplasty...
July 15, 2016: A & A Case Reports
Metha Brattwall, Pether Jildenstål, Margareta Warrén Stomberg, Jan G Jakobsson
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues...
2016: F1000Research
Tariq Malik, Daniel Mass, Stephan Cohn
PURPOSE: To compare the analgesic efficacy of 3-day continuous interscalene brachial plexus block versus a single-shot block for arthroscopic rotator cuff repair. METHODS: Eighty-five patients scheduled for arthroscopic rotator cuff repair were randomly assigned to either the single-shot group (SSG) or continuous interscalene brachial block group (CG). Patients in the SSG received 2.5 mg/kg of 0.5% bupivacaine up to 25 mL; the CG received the same dose as a loading dose via catheter followed by an infusion of 0...
August 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
T Wiesmann, C Feldmann, H H Müller, L Nentwig, A Beermann, B F El-Zayat, M Zoremba, H Wulf, T Steinfeldt
BACKGROUND: Hemidiaphragmatic palsy is a common consequence of the interscalene brachial plexus block. It occurs less commonly with the supraclavicular approach. Register data suggest that the analgesic quality of a supraclavicular blockade is sufficient for arthroscopic shoulder surgery, although data on the post-operative analgesic effect are lacking. METHODS: After approval by the ethics committee, patients having arthroscopic shoulder surgery under general anaesthesia were randomized to receive a continuous interscalene or supraclavicular blockade...
September 2016: Acta Anaesthesiologica Scandinavica
A Pawa, A P Devlin, A Kochhar
No abstract text is available yet for this article.
April 2016: Anaesthesia
M J Fredrickson, P Leightley, A Wong, M Chaddock, A Abeysekera, C Frampton
Continuous interscalene brachial plexus block has been shown to be the most effective analgesic technique following shoulder surgery; however, its use is uncommon due to logistical and safety concerns related to ambulatory administration. We prospectively studied 1505 consecutive patients undergoing shoulder surgery who received continuous interscalene analgesia at home. Catheter removal was by the patient between postoperative days two and five. There were no major complications although 27% of patients reported mild dyspnoea, 13% hoarseness and 7% dysphagia...
April 2016: Anaesthesia
Mumin Hakim, Candice Burrier, Tarun Bhalla, Vidya T Raman, David P Martin, Olamide Dairo, Joel L Mayerson, Joseph D Tobias
Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement...
2015: Journal of Pain Research
Karen T Bjørnholdt, Jan M Jensen, Thomas F Bendtsen, Kjeld Søballe, Lone Nikolajsen
BACKGROUND: Shoulder replacement involves significant post-operative pain, which is often managed by continuous interscalene brachial plexus block. Catheter displacement and complications limit the beneficial effect of the block. Local infiltration analgesia (LIA) has provided good results in knee replacement. We aimed to assess the effectiveness of LIA for pain after shoulder replacement. METHODS: Patients scheduled for primary shoulder replacement under general anaesthesia were randomized to receive either local infiltration analgesia (LIA) (150 ml ropivacaine 0...
December 2015: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Dominik W Choromanski, Pranav S Patel, Joel M Frederick, Stephen E Lemos, Elie J Chidiac
STUDY OBJECTIVE: Outpatient continuous interscalene brachial plexus blocks containing bupivacaine or ropivacaine are commonly used to control pain after shoulder surgery. Interscalene blocks cause hemidiaphragmatic paresis. Because ropivacaine preferentially blocks sensory fibers, it may cause less blockade of the phrenic nerve. The purpose of this study was to evaluate the effects of 2 common continuous interscalene brachial plexus infusions: 0.125% bupivacaine vs 0.2% ropivacaine. The study hypothesis is that respiratory function will be less attenuated using ropivacaine than bupivacaine without affecting pain relief...
December 2015: Journal of Clinical Anesthesia
Gyeong Jo Byeon, Sang Wook Shin, Ji Uk Yoon, Eun Jung Kim, Seung Hoon Baek, Hyun Su Ri
BACKGROUND: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. METHODS: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32)...
July 2015: Korean Journal of Pain
Thomas Wiesmann, Pascal Wallot, Laura Nentwig, Alisha-Viktoria Beermann, Hinnerk Wulf, Martin Zoremba, Turfa Al-Dahna, Daphne Eschbach, Thorsten Steinfeldt
PURPOSE: Stimulating catheters are widely used for continuous peripheral nerve block techniques in regional anesthesia. The incidence of reported complications is somewhat similar to that for non-stimulating catheters. However, as many stimulating catheters contain a coiled steel wire for optimal stimulation, they may cause specific complications. CLINICAL FEATURES: In this report, we present two cases of complicated removals of stimulating catheters. During both removals, a part of the metal wire was left "decoiled" next to the supraclavicular and interscalene plexus, respectively...
2015: Local and Regional Anesthesia
Martin Zoremba, Thomas Kratz, Frank Dette, Hinnerk Wulf, Thorsten Steinfeldt, Thomas Wiesmann
BACKGROUND: After shoulder surgery performed in patients with interscalene nerve block (without general anesthesia), fast track capability and postoperative pain management in the PACU are improved compared with general anesthesia alone. However, it is not known if these evidence-based benefits still exist when the interscalene block is combined with general anesthesia. METHODS: We retrospectively analyzed a prospective cohort data set of 159 patients undergoing shoulder arthroscopy with general anesthesia alone (n = 60) or combined with an interscalene nerve block catheter (n = 99) for fast track capability time...
2015: BioMed Research International
H Gurnaney, W T Muhly, F W Kraemer, G Cucchiaro, A Ganesh
BACKGROUND: The use of interscalene catheters is an effective treatment strategy for children and adolescents undergoing shoulder surgery. Although placement of interscalene catheters in the awake child is challenging, some have cautioned against performing regional anesthesia in the patient under general anesthesia. We present a case series of 154 interscalene catheters placed in pediatric patients under general anesthesia and managed in the outpatient setting. METHODS: A total of 154 interscalene catheters were placed at a single institution between April 2006 and December 2011 using a modified lateral approach...
March 2015: Acta Anaesthesiologica Scandinavica
Patricia Chamorro Ceron, Irene Iselin, Pierre Hoffmeyer, Roxane Fournier
Perineural catheters are the technique of choice for postoperative analgesia after painful orthopedic surgery. Infectious complications associated with perineural catheters, although rare, are associated with increased morbidity and mortality, medical cost, and hospital length of stay. In this report, we describe a patient in whom a cervical abscess occurred after insertion of an ultrasound-guided interscalene catheter.
September 1, 2014: A & A Case Reports
Michael C Gemayel, Joseph E Chidiac, Elie J Chidiac
Continuous peripheral nerve blocks are used in the management of pain following surgical procedures. They can also be used in patients with cancer-related pain, to improve sleep quality, reduce opioid requirements and their side effects. We describe two cancer patients in whom interscalene brachial plexus catheters were used on an outpatient basis, allowing them to travel, decrease their opioid use, and improve their ability to perform routine activities.
March 2015: Journal of Pain & Palliative Care Pharmacotherapy
Perry G Fine
The value and importance of improved communication and collaboration among pain management and palliative care clinicians is presented. The commentator uses the case report in this issue of the journal on the use of indwelling catheters for continuous interscalene blocks in cancer pain management as an example of why these two medical subspecialties need improved collaboration and integration.
March 2015: Journal of Pain & Palliative Care Pharmacotherapy
Yue Wei, Min Li, Yulan Rong, Xiangyang Guo
BACKGROUND: Continuous interscalene nerve block (CISB) is considered to be the most effective method for postoperative analgesia after shoulder surgery with prolonged severe pain. This study was performed to evaluate the minimum effective background infusion rate and the effective background infusion rate of ropivacaine 0.2% for CISB after arthroscopic rotator cuff repair surgery in 95% of patients. METHODS: Patients scheduled for arthroscopic rotator cuff repair surgery under general anesthesia at Peking University Third Hospital were prospectively enrolled from December 2011 to May 2012...
2014: Chinese Medical Journal
T Berndt, S Elki, A Sedlinsch, S Lerch
OBJECTIVE: Arthroscopic capsular release for refractory shoulder stiffness to recreate active and passive shoulder joint mobility. INDICATIONS: Adhesive capsulitis of the shoulder (primary and secondary frozen shoulder) after receiving at least 3 months of conservative treatment. CONTRAINDICATIONS: Boney-related stiffening of the shoulder joint, joint infection, freezing phase of the primary frozen shoulder and shoulder stiffness after reconstructive surgery...
April 2015: Operative Orthopädie und Traumatologie
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