Incidence of Horner Syndrome with Interscalene Brachial Plexus Block and Its Importance in the Management of Head Injury

Al-Khafaji, Jamal M.; Ellias, Mazin

doi:10.1097/00000542-198601000-00028

Cited by 15 publications

(1 citation statement)

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“…Information about the true incidence of Horner's syndrome during ISB, its relationship with the kind and dose of local anesthetic solution and the use of epinephrine as additive to this solution, or the block technique are scarce. In the past, it has been reported that in 248 patients with ISB, 46 (18.5%) developed Horner's syndrome [23]. More recently, the reported incidence reached to 53.3% [17].…”

Section: Discussionmentioning

confidence: 99%

Effect of interscalene brachial plexus block on heart rate variability

Simeoforidou

Vretzakis

Chantzi

et al. 2013

Korean J Anesthesiol

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BackgroundInterscalene brachial plexus block (ISB) may be followed by cardiovascular instability. Until date, there is no clear picture available about the underlying mechanisms of ISB. In this study, we aimed to determine the changes in heart rate variability (HRV) parameters after ISB and the differences between right- and left-sided ISBs.MethodsWe prospectively studied 24 patients operated for shoulder surgery in sitting position and divided them into two respective groups: R (right-sided block = 14 pts) and L (left-sided block = 10 pts). HRV data were taken before and 30 min after the block. Ropivacaine without ephedrine was used for the ISB through an insulated block needle connected to a nerve stimulator. Statistical analysis implemented chi-square, Student's and t-paired tests. Skewed distributions were analyzed after logarithmic transformation.ResultsAll the studied patients had successful blocks. Horner's syndrome signs were observed in 33.3% of the patients (R = 5/14, L = 3/10; [P = 0.769]). There were no significant differences in pre-block HRV between the groups. The application of ISB had differential effect on HRV variables: R-blocks increased QRS and QTc durations and InPNN50, while a statistical decrease was seen in InLF. L-blocks did not show any significant changes. These changes indicate a reduced sympathetic and an increased parasympathetic influence on the heart's autonomic flow after R-block.ConclusionsBased on the obtained results we conclude that ISB, possibly through extension of block to the ipsilateral stellate ganglion, alters the autonomic outflow to the central circulatory system in a way depending on the block's side.

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Section: Discussionmentioning

confidence: 99%