A Prospective Clinical Registry of Ultrasound-Guided Regional Anesthesia for Ambulatory Shoulder Surgery

Liu, Spencer S.; Gordon, Michael A.; Shaw, Pamela; Wilfred, Sarah E.; Shetty, Teena; YaDeau, Jacques T.

doi:10.1213/ane.0b013e3181ea5f5d

Cited by 159 publications

(122 citation statements)

References 22 publications

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“…Both blocks were found to have similar effectiveness, while the supraclavicular block (Video 2, available as ESM) was associated with a reduced rate of postoperative hoarseness. 12 Some authors suggest that the anatomical characteristics of the brachial plexus at the level of the supraclavicular fossa (more fascicles but smaller in size) may explain the reduced risk of neurological damage associated with the supraclavicular block compared with the interscalene block, while offering equivalent block success. 13 However, there is no direct clinical evidence for this explanation.…”

Section: Shouldermentioning

confidence: 99%

“…For this indication, volumes of [ 30 mL are used in the majority of studies. 12 Supraclavicular approach…”

Section: Interscalene Approachmentioning

confidence: 99%

“…Le bloc supraclaviculaire (Vidéo 2, disponible en matériel électronique supplémentaire) s'est avéré d'une efficacité comparable, tout en diminuant l'incidence de raucité de la voix en postopératoire. 12 Certains auteurs suggèrent que les caractéristiques anatomiques du plexus brachial au niveau de la fosse supraclaviculaire (augmentation du nombre mais diminution de la grosseur des fascicules) pourraient permettre une diminution du risque de lésion nerveuse lors du bloc supraclaviculaire comparativement au bloc interscalénique tout en offrant une anesthésie équivalente. 13 Les preuves cliniques de cette affirmation restent à faire.…”

Section: Technique De Localisation Nerveuseunclassified

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Ultrasound-guided regional anesthesia for upper limb surgery

Nadeau

Lévesque

Dion

2013

Can J Anesth/J Can Anesth

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Section: Shouldermentioning

confidence: 99%

“…For this indication, volumes of [ 30 mL are used in the majority of studies. 12 Supraclavicular approach…”

Section: Interscalene Approachmentioning

confidence: 99%

Section: Technique De Localisation Nerveuseunclassified

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Ultrasound-guided regional anesthesia for upper limb surgery

Nadeau

Lévesque

Dion

2013

Can J Anesth/J Can Anesth

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“…Regional anesthetic techniques have been recognized as effective for analgesic management and improved patient satisfaction after shoulder arthroplasty [14,20]. Evidence is available that the use of regional anesthesia for orthopaedic surgery of the upper extremity conveys desirable advantages, including decreased baseline and dynamic pain, lower consumption of systemic analgesics, decrease of joint inflammation, increase in patient satisfaction, earlier mobilization, and shorter time to discharge readiness [1,14].…”

Section: Discussionmentioning

confidence: 99%

“…Regional anesthesia has proven to be an effective technique for the anesthetic and analgesic management of patients undergoing shoulder surgery [14,20]. Upper-extremity peripheral nerve block techniques frequently are utilized in combination with general anesthesia as a strategy to reduce requirement for systemic analgesics, facilitate rehabilitation, and potentially allow for earlier discharge after total shoulder arthroplasty [5,27,31].…”

Section: Introductionmentioning

confidence: 99%

Peripheral Nerve Blocks in Shoulder Arthroplasty: How Do They Influence Complications and Length of Stay?

Stundner

Rasul

Chiu

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Regional anesthesia has proven to be a highly effective technique for pain control after total shoulder arthroplasty. However, concerns have been raised about the safety of upper-extremity nerve blocks, particularly with respect to the incidence of perioperative respiratory and neurologic complications, and little is known about their influence, if any, on length of stay after surgery. Questions/purposes Using a large national cohort, we asked: (1) How frequently are upper-extremity peripheral nerve blocks added to general anesthesia in patients undergoing total shoulder arthroplasty? (2) Are there differences in the incidence of and adjusted risk for major perioperative complications and mortality between patients receiving general anesthesia with and without nerve blocks? And (3) does resource utilization (blood product transfusion, intensive care unit admission, length of stay) differ between groups? Methods We searched a nationwide discharge database for patients undergoing total shoulder arthroplasty under general anesthesia with or without addition of a nerve Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. The institution of one of the authors (SGM) has received, during the study, funding from the Anna-Maria and Stephen Kellen Physician-Scientist Career Development Award provided by the Hospital for Special Surgery. One or more of the authors (RR, YLC, XS, MM) has received, during the study,

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Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department

Goldsmith,

Driver,

Duggan

et al. 2024

JAMA Netw Open

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ImportanceUltrasonography-guided nerve blocks (UGNBs) have become a core component of multimodal analgesia for acute pain management in the emergency department (ED). Despite their growing use, national adoption of UGNBs has been slow due to a lack of procedural safety in the ED.ObjectiveTo assess the complication rates and patient pain scores of UGNBs performed in the ED.Design, Setting, and ParticipantsThis cohort study included data from the National Ultrasound-Guided Nerve Block Registry, a retrospective multicenter observational registry encompassing procedures performed in 11 EDs in the US from January 1, 2022, to December 31, 2023, of adult patients who underwent a UGNB.ExposureUGNB encounters.Main Outcomes and MeasuresThe primary outcome of this study was complication rates associated with ED-performed UGNBs recorded in the National Ultrasound-Guided Nerve Block Registry from January 1, 2022, to December 31, 2023. The secondary outcome was patient pain scores of ED-based UGNBs. Data for all adult patients who underwent an ED-based UGNB at each site were recorded. The volume of UGNB at each site, as well as procedural outcomes (including complications), were recorded. Data were analyzed using descriptive statistics of all variables.ResultsIn total, 2735 UGNB encounters among adult patients (median age, 62 years [IQR, 41-77 years]; 51.6% male) across 11 EDs nationwide were analyzed. Fascia iliaca blocks were the most commonly performed UGNBs (975 of 2742 blocks [35.6%]). Complications occurred at a rate of 0.4% (10 of 2735 blocks). One episode of local anesthetic systemic toxicity requiring an intralipid was reported. Overall, 1320 of 1864 patients (70.8%) experienced 51% to 100% pain relief following UGNBs. Operator training level varied, although 1953 of 2733 procedures (71.5%) were performed by resident physicians.Conclusions and RelevanceThe findings of this cohort study of 2735 UGNB encounters support the safety of UGNBs in ED settings and suggest an association with improvement in patient pain scores. Broader implementation of UGNBs in ED settings may have important implications as key elements of multimodal analgesia strategies to reduce opioid use and improve patient care.

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A Prospective Clinical Registry of Ultrasound-Guided Regional Anesthesia for Ambulatory Shoulder Surgery

Abstract: Ultrasound-guided interscalene and supraclavicular blocks are effective and safe for shoulder arthroscopy. Temporary and permanent PONS is uncommon.

Cited by 159 publications

References 22 publications

Ultrasound-guided regional anesthesia for upper limb surgery

Ultrasound-guided regional anesthesia for upper limb surgery

Peripheral Nerve Blocks in Shoulder Arthroplasty: How Do They Influence Complications and Length of Stay?

Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department

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