scholarly journals Randomized, comparative study of the effectiveness of three different techniques of interscalene brachial plexus block using 0.5% ropivacaine for shoulder arthroscopy

2017 ◽  
Vol 49 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Michał Kolny ◽  
Michał J. Stasiowski ◽  
Marek Zuber ◽  
Radosław Marciniak ◽  
Ewa Chabierska ◽  
...  
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Shoulder Arthroscopy ◽  
Interscalene Brachial Plexus Block ◽  
Plexus Block

scholarly journals Comparative evaluation of regional blockades during arthroscopic shoulder surgery

2018 ◽  
Vol 12 (4) ◽  
pp. 242-249
Author(s):  
K. S. Trukhin ◽  
Dmitry V. Zabolotskii ◽  
V. A. Koriachkin ◽  
O. V. Kuleshov ◽  
A. A. Cherednichenko ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Rating Scale ◽  
Brachial Plexus Block ◽  
Shoulder Arthroscopy ◽  
Arthroscopic Surgery ◽  
Neurological Complications ◽  
Patient Comfort ◽  
Narcotic Analgesics ◽  
Interscalene Brachial Plexus Block ◽  
Plexus Block

Objective: To evaluate the effectiveness of interscalene brachial plexus block versus combined suprascapular and axillary nerves block for shoulder arthroscopy. Methods: In this prospective study 174 patients were operated on the shoulder joint by the arthroscopic method under combined anesthesia. In the 1st group (n=96), for the purpose of analgesia, patients got interscalene brachial plexus block; in the 2nd group (n=78), patients received suprascapular and axillary nerves block. Ultrasound visualization and neurostimulation were used in both groups. Recorded the time from the start of blockade to the start of the operation, as well as the duration of the sensory and motor blockade. The intensity of postoperative pain was assessed with a 10-point Numeric rating scale, the need for additional analgesia, the quality of night sleep, and patient comfort. Neurological complications were also recorded. Results: There were no differences in the time from the admit patients to the operating room and before the start surgery. The analgesic effect in the early postoperative period in the 1st group was higher, but by the end of the first day there was no statistical difference between the groups in the intensity of the pain syndrome. Intake of non-narcotic and narcotic analgesics was higher in the 2nd group. Complications were noted only for the 1st group: diaphragm paresis in 6 (6.25%) patients, in 2 (2.08%) recurrent laryngeal nerve blockade. Satisfaction with postoperative analgesia was 100% in patients of the 2nd group. The choice of regional anesthesia for arthroscopic interventions on the shoulder did not affect the length of hospitalization. Conclusion: Selective anesthesia of the suprascapular and axillary nerves during shoulder arthroscopic surgery is an alternative of interscalene brachial plexus block; it is not associated by respiratory and neurological complications; does not violate movements in the distal upper limb, reduces psychological discomfort and anxiety of patients.

scholarly journals Effect of brachial plexus block on the incidence of arterial hypotension and bradycardia events during shoulder arthroscopy in adolescents

2020 ◽  
Vol 8 (1) ◽  
pp. 35-42
Author(s):  
Konstantin S. Trukhin ◽  
Dmitrii V. Zabolotskii ◽  
Viktor A. Koriachkin ◽  
Oleg V. Kuleshov ◽  
Kirill I. Zakharov ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Local Anesthetic ◽  
Brachial Plexus Block ◽  
Shoulder Arthroscopy ◽  
Sitting Position ◽  
Interscalene Brachial Plexus Block ◽  
Group 3 ◽  
Group 2 ◽  
Plexus Block ◽  
Group 1

Background. The role and significance of the technical aspects of interscalene brachial plexus block in the occurrence of sudden arterial hypotension and bradycardia events during shoulder arthroscopy in a semi-sitting position are ambiguous. Aim. The study aimed to assess the effect of interscalene brachial plexus block on the incidence of hypotension-bradycardia events during shoulder arthroscopic surgery in adolescents in a semi-sitting position. Materials and methods. This retrospective analysis of anesthesia protocols included 288 patients who underwent arthroscopic shoulder surgery in a semi-sitting position under the interscalene brachial plexus block. Regional blockades were performed with neurostimulation in Group 1 (n = 23), neurostimulation and ultrasound navigation without repositioning the needle in Group 2 (n = 70), and neurostimulation and ultrasound navigation with multiple precision repositioning the needle in Group 3 (n = 195). Results. Hypotension-bradycardia events were detected in 26 patients out of 288 (9%). There was a statistically significant difference in the frequency of hypotension-bradycardia in all groups: 10 (43.48%) in Group 1, 15 (21.43%) in Group 2, and 1 (0.51%) in Group 3 (p = 0.000). A direct correlation between hypotension-bradycardia episodes and local anesthetic volume (r = 0.405; p 0.05), and Horners syndrome (r = 0.684, p 0.05) was found. Conclusions. Interscalene brachial plexus block with a target delivery of low volume of local anesthetic and dual navigation reduces the risk of hypotension-bradycardia. Horners syndrome can be considered an early predictor of hypotension-bradycardia events.

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