ESRA19-0216 Respiratory complications after interscalene brachial plexus block versus a shoulder block: a randomized, controlled, single-blinded trial

2019 ◽  
Author(s):  
P Rhyner ◽  
R Midez ◽  
A Farron ◽  
E Albrecht
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Respiratory Complications ◽  
Interscalene Brachial Plexus Block ◽  
Randomized Controlled ◽  
Plexus Block ◽  
Blinded Trial

scholarly journals Bilateral Vocal Cord Palsy following Interscalene Brachial Plexus Nerve Block

2002 ◽  
Vol 30 (4) ◽  
pp. 499-501 ◽  
Author(s):  
M. L. Plit ◽  
P. N. Chhajed ◽  
P. Macdonald ◽  
I. E. Cole ◽  
G. A. Harrison
Keyword(s):  
Brachial Plexus ◽  
Vocal Cord ◽  
Brachial Plexus Block ◽  
Significant Risk ◽  
Vocal Cord Palsy ◽  
Respiratory Complications ◽  
Interscalene Brachial Plexus Block ◽  
Plexus Block ◽  
Hemi Arthroplasty

Acute respiratory complications of an interscalene brachial plexus block include ipsilateral phrenic nerve and recurrent laryngeal nerve palsies. A 71-year-old woman who had undergone a total thyroidectomy for papillary carcinoma 35 years ago was administered a right interscalene brachial plexus block for a shoulder hemi-arthroplasty. Subsequently she developed acute respiratory distress associated with marked stridor secondary to an acute right vocal cord palsy, which was superimposed on what was assumed to be a preexisting left-sided vocal cord palsy. On extubation the patient was noted to develop stridor again necessitating reintubation and tracheostomy was performed two weeks later. The vocal cord palsies failed to resolve over the subsequent 18-month follow-up. We describe this case to highlight the significant risk of this procedure in patients with preexisting or suspected contralateral vocal cord palsy.

scholarly journals Comparison of Diaphragmatic Paralysis, Respiratory Function and Postoperative Pain After Interscalene Brachial Plexus Block With a Reduction Dose of Levobupivacaine 0.25% 10 ml Versus 20 ml Undergoing Arthroscopic Shoulder Surgery: Study Protocol for the Randomized, Controlled and Double-blinded REDOLEV Study.

2020 ◽  
Author(s):  
Pablo Oliver-Fornies ◽  
Pablo Ortega Lahuerta ◽  
Roberto Gomez Gomez ◽  
Inmaculada Gonzalo Pellicer ◽  
Leticia Oliden Gutierrez ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Shoulder Surgery ◽  
Patient Controlled Analgesia ◽  
Interscalene Brachial Plexus Block ◽  
Randomized Controlled ◽  
Arthroscopic Shoulder Surgery ◽  
Low Volume ◽  
Plexus Block

Abstract Background: Arthroscopic shoulder surgery involves dynamic and severe postoperative pain. Interscalene brachial plexus block provides adequate analgesia, but the spread of local anaesthetics administered causes a phrenic nerve block that entrains a nonnegligible incidence of hemidiaphragmatic paralysis acute.The main objective of this trial is to compare the hemidiaphragmatic paralysis after interscalene brachial plexus block in arthroscopic shoulder surgery, between a standard volume (20 ml) and a low volume (10 ml) of 0.25% levobupivacaine.Methods: This is a comparative, prospective, single-center, double-blind, two-arm randomized controlled trial. Forty-eight patients will be included. The primary end-point is to determine the hemidiaphragmatic paralysis incidence diagnosed by the diaphragmatic thickness ratio in ultrasound. The secondary endpoints are as follows: (1) hemidiaphragmatic paralysis incidence diagnosed by forced vital capacity and (2) forced expiratory volume at 1 second decrease in spirometry; (3) hemidiaphragmatic paralysis incidence diagnosed by using diaphragmatic excursion decrease in ultrasound; (4) postoperative pain regarding 24-hour morphine intravenous total consumption and (5) time to first analgesic consumption of patient-controlled analgesia pump; and (6) postoperative harm between the two trial arms.Discussion: This trial would demonstrate that low-volume interscalene brachial plexus block decreases hemidiaphragmatic paralysis in arthroscopic shoulder surgery by using spirometry and ultrasound and would not provide inferior postoperative analgesia according to opioid requirements of postoperative patient-controlled analgesia in comparison to the standard volume used in current practice.Trial registration: EudraCT and Spanish Trial Register (REec) registration number: 2019-003855-12 (Registered on 07 January 2020). ClinicalTrials.gov identification number: NCT04385966 (Retrospectively registered on 08 May 2020). Ethics Committee approval: EC19/093 (18 Dic 2019).

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