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Interscalene nerve catheter

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https://www.readbyqxmd.com/read/28898151/postoperative-analgesia-for-shoulder-surgery
#1
Neel Desai
Both arthroscopic and open surgery of the shoulder are associated with significant postoperative pain. Use of opioids can result in adverse systemic effects, so a multi-modal analgesic approach and complementary analgesic techniques should be considered to minimize the postoperative opioid requirement. Single shot interscalene block provides effective pain control of early and limited duration which can be extended with a catheter. Continuous interscalene block should be considered for more invasive shoulder procedures...
September 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28844420/a-prospective-randomized-controlled-trial-to-identify-the-optimal-postoperative-pain-management-in-shoulder-arthroplasty-liposomal-bupivacaine-versus-continuous-interscalene-catheter
#2
Vani J Sabesan, Rajin Shahriar, Graysen R Petersen-Fitts, James D Whaley, Therese Bou-Akl, Matthew Sweet, Marc Milia
BACKGROUND: Shoulder arthroplasty is the fastest growing joint replacement surgery in the United States, and optimal postoperative pain management is critical to optimize outcomes for these surgeries. Liposomal bupivacaine (LB) has gained popularity for its potential to provide extended postoperative pain relief with possibly fewer side effects. The goal of this study was to assess the impact of LB compared with continuous interscalene nerve block (CISB) in terms of postoperative pain control, outpatient pain scores, and patient-reported and functional outcomes after shoulder arthroplasty surgery...
August 22, 2017: Journal of Shoulder and Elbow Surgery
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
#3
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/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#4
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/28151818/the-effect-of-fixation-technique-on-continuous-interscalene-nerve-block-catheter-success-a-randomized-double-blind-trial
#5
RANDOMIZED CONTROLLED TRIAL
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/27920572/home-peripheral-nerve-catheters-the-first-24-months-of-experience-at-a-children-s-hospital
#6
Andrew Gable, Candice Burrier, Jenna Stevens, Sharon Wrona, Kevin Klingele, Tarun Bhalla, David P Martin, Giorgio Veneziano, Joseph D Tobias
CONTEXT: Home peripheral nerve catheters (PNCs) have become common practice for adult patients after major orthopedic surgery. However, use in pediatric patients is a recent application. OBJECTIVES: The purpose of this study was to review the demographics and outcomes of pediatric patients receiving a PNC at our institution. METHODS: This retrospective study included patients from October 2012 through October 2014 undergoing orthopedic procedures with a PNC placed for postoperative pain management...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#7
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/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
#8
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/27377713/current-practice-in-regional-anaesthesia-in-south-america-an-online-survey
#9
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...
January 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27258178/continuous-suprascapular-nerve-block-with-a-perineural-catheter-for-reverse-shoulder-arthroplasty-rescue-analgesia-in-a-patient-with-severe-chronic-obstructive-pulmonary-disease
#10
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
https://www.readbyqxmd.com/read/27239291/upper-extremity-nerve-block-how-can-benefit-duration-and-safety-be-improved-an-update
#11
REVIEW
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
https://www.readbyqxmd.com/read/27098548/phrenic-palsy-and-analgesic-quality-of-continuous-supraclavicular-vs-interscalene-plexus-blocks-after-shoulder-surgery
#12
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26849172/an-analysis-of-1505-consecutive-patients-receiving-continuous-interscalene-analgesia-at-home-a-multicentre-prospective-safety-study
#13
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/26216250/the-effect-of-continuous-interscalene-brachial-plexus-block-with-0-125-bupivacaine-vs-0-2-ropivacaine-on-pain-relief-diaphragmatic-motility-and-ventilatory-function
#14
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26175882/infusion-methods-for-continuous-interscalene-brachial-plexus-block-for-postoperative-pain-control-after-arthroscopic-rotator-cuff-repair
#15
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
https://www.readbyqxmd.com/read/26170716/separation-of-stimulating-catheters-for-continuous-peripheral-regional-anesthesia-during-their-removal-two-case-reports-and-a-critical-appraisal-of-the-use-of-steel-coil-containing-stimulating-catheters
#16
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
https://www.readbyqxmd.com/read/26064898/supplemental-interscalene-blockade-to-general-anesthesia-for-shoulder-arthroscopy-effects-on-fast-track-capability-analgesic-quality-and-lung-function
#17
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
https://www.readbyqxmd.com/read/25562724/ambulatory-continuous-interscalene-blocks-for-cancer-pain
#18
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
https://www.readbyqxmd.com/read/25430460/effective-background-infusion-rate-of-ropivacaine-0-2-for-patient-controlled-interscalene-brachial-plexus-analgesia-after-rotator-cuff-repair-surgery
#19
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
https://www.readbyqxmd.com/read/25304482/interscalene-brachial-plexus-blocks-under-general-anesthesia-in-children-is-this-safe-practice-a-report-from-the-pediatric-regional-anesthesia-network-pran
#20
Andreas Taenzer, Benjamin J Walker, Adrian T Bosenberg, Elliot J Krane, Lynn D Martin, David M Polaner, Christie Wolf, Santhanam Suresh
BACKGROUND AND OBJECTIVES: A practice advisory on regional anesthesia in children in 2008, published in this journal, supported the placement of regional blocks in children under general anesthesia (GA). Interscalene brachial plexus (IS) blocks were specifically excluded, based on case reports (level 3 evidence) of injury, which occurred predominantly in heavily sedated or anesthetized adult patients. Apart from case reports, there is a paucity of data that explore the safety of IS blocks placed in patients under GA, and the level of evidence available on which to base recommendations is limited...
November 2014: Regional Anesthesia and Pain Medicine
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