scholarly journals The effect of interscalene brachial plexus block with propofol sedation on preventing perioperative hypothermia during arthroscopic shoulder surgery

2020 ◽  
Author(s):  
Ji Hye Lee ◽  
Hyun Joo Heo ◽  
Yu Yil Kim ◽  
Seung Min Baek ◽  
Ki Man Kim ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Shoulder Surgery ◽  
Interscalene Brachial Plexus Block ◽  
Propofol Sedation ◽  
Perioperative Hypothermia ◽  
Arthroscopic Shoulder Surgery ◽  
Plexus Block

Superior Trunk Block Provides Noninferior Analgesia Compared with Interscalene Brachial Plexus Block in Arthroscopic Shoulder Surgery

2019 ◽  
Vol 131 (6) ◽  
pp. 1316-1326 ◽  
Author(s):  
RyungA Kang ◽  
Ji Seon Jeong ◽  
Ki Jinn Chin ◽  
Jae Chul Yoo ◽  
Jong Hwan Lee ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Brachial Plexus Block ◽  
Group Versus ◽  
Shoulder Surgery ◽  
Interscalene Block ◽  
Block Group ◽  
Interscalene Brachial Plexus Block ◽  
Arthroscopic Shoulder Surgery ◽  
Plexus Block

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Interscalene brachial plexus block of the C5–C6 roots provides highly effective postoperative analgesia after shoulder surgery but usually results in hemidiaphragmatic paresis. Injection around the superior trunk of the brachial plexus is an alternative technique that may reduce this risk. The authors hypothesized that the superior trunk block would provide noninferior postoperative analgesia compared with the interscalene block and reduce hemidiaphragmatic paresis. Methods Eighty patients undergoing arthroscopic shoulder surgery were randomized to receive a preoperative injection of 15 ml of 0.5% ropivacaine and 5 μg · ml−1 epinephrine around either (1) the C5–C6 nerve roots (interscalene block group) or (2) the superior trunk (superior trunk block group). The primary outcome was pain intensity 24 h after surgery measured on an 11-point numerical rating score; the prespecified noninferiority limit was 1. Diaphragmatic function was assessed using both ultrasonographic measurement of excursion and incentive spirometry by a blinded investigator before and 30 min after block completion. Results Seventy-eight patients completed the study. The pain score 24 h postoperatively (means ± SDs) was 1.4 ± 1.0 versus 1.2 ± 1.0 in the superior trunk block (n = 38) and interscalene block (n = 40) groups, respectively. The mean difference in pain scores was 0.1 (95% CI, −0.3 to 0.6), and the upper limit of the 95% CI was lower than the prespecified noninferiority limit. Analgesic requirements and all other pain measurements were similar between groups. Hemidiaphragmatic paresis was observed in 97.5% of the interscalene block group versus 76.3% of the superior trunk block group (P = 0.006); paresis was complete in 72.5% versus 5.3% of the patients, respectively. The decrease in spirometry values from baseline was significantly greater in the interscalene block group. Conclusions The superior trunk block provided noninferior analgesia compared with interscalene brachial plexus block for up to 24 h after arthroscopic shoulder surgery and resulted in significantly less hemidiaphragmatic paresis.

scholarly journals A prospective, randomized and controlled study of interscalene brachial plexus block for arthroscopic shoulder surgery

Medicine ◽  
2016 ◽  
Vol 95 (37) ◽  
pp. e4921 ◽  
Author(s):  
Hyun-Jung Shin ◽  
Hyo-Seok Na ◽  
Ah-Young Oh ◽  
Jung-Won Hwang ◽  
Byung-Gun Kim ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Shoulder Surgery ◽  
Controlled Study ◽  
Interscalene Brachial Plexus Block ◽  
Arthroscopic Shoulder Surgery ◽  
Plexus Block

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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