Interscalene Block Anesthesia for Shoulder Surgery

Conn, Richard A.; Cofield, Robert H.; Byer, David E.; Linstromberg, John W.

doi:10.1097/00003086-198703000-00015

Cited by 61 publications

(32 citation statements)

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“…13 However, the study was limited to only 50 patients and a definition of "obese" is missing. In contrast, Conn et al 12 found no association between block failure and patient height or weight. Likewise, Carles et al 7 found no association between block failure and patient characteristics in a study of 1,468 brachial plexus blocks performed at the humeral canal with a nerve stimulator.…”

Section: Discussionmentioning

confidence: 91%

“…7 The experience of the anesthesiologist placing the block has been reported to impact the rate of success by some authors, [8][9][10][11] but this finding is controversial. 12 Moreover, obesity and patient non-compliance have been reported as risk factors for block failure. 13 Despite these technical variables that contribute to failure, limited studies have examined patient characteristics associated with increased block failure.…”

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confidence: 99%

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Increased body mass index and ASA physical status IV are risk factors for block failure in ambulatory surgery — an analysis of 9,342 blocks

Cotter

Nielsen

Güller

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Regional anesthesia can be the technique of choice for selected ambulatory surgery procedures, but in spite of its benefits, it has an inherent failure rate even in experienced hands. We examine the efficacy and factors associated with failure of ambulatory regional anesthesia techniques. M Me et th ho od ds s: :This study included 9,342 blocks performed on 7,160 patients at the Duke University Ambulatory Surgery Center. Blocks were classified as interscalene, supraclavicular, axillary, lumbar plexus, femoral, sciatic, ankle, paravertebral, spinal, and other (frequency less than 100). A block was considered surgical if a single attempt at placing the block resulted in a complete sensory, motor, and sympathetic nerve block. Multiple logistic regression analyses were used to assess the risk-adjusted association between patient characteristics and block failure.R Re es su ul lt ts s: : Paravertebral blocks and those considered in the "other" category had significantly higher failure rates (P < 0.001), while spinal and lumbar plexus blocks had lower than average rates of failure (P < 0.001 and P = 0.03, respectively).In multiple logistic regression analyses excluding paravertebral blocks, body mass index (BMI) scores greater than 25 (P values: BMI 25-29: < 0.001; BMI 30-34: P < 0.001; BMI 35: P < 0.001) and ASA physical status IV (P < 0.001) were significantly associated with higher block failure rates.C Co on nc cl lu us si io on n: : High BMI and ASA IV are independent risk factors for block failure in ambulatory surgery patients. (P < 0,001 et P = 0,03, respectivement Objectif : L'anesthésie régionale peut être la technique de choix pour certaines interventions chirurgicales ambulatoires, mais en dépit de ses avantages, elle présente un taux d'échec inhérent même entre des mains expertes. Nous vérifions l'efficacité des techniques d'anesthésie régionale ambulatoire et les facteurs associés à son échec. Méthode

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Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

Increased body mass index and ASA physical status IV are risk factors for block failure in ambulatory surgery — an analysis of 9,342 blocks

Cotter

Nielsen

Güller

et al. 2004

Can J Anesth/J Can Anesth

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“…Even in a small dose, single dose ISB provides significant analgesia. 2,4,5 However, ISB is associated with potential serious complications, which include inadvertent epidural and spinal anaesthesia, vertebral artery injection, paralysis of vagus, recurrent laryngeal and cervical sympathetic nerves block, 6 etc. Phrenic nerve block occurs in all patients undergoing ISB.…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of post-operative analgesia comparing suprascapular nerve block and interscalene brachial plexus block in patients undergoing shoulder arthroscopic surgery

Kumara

Gogia

Bajaj

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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Suprascapular nerve blockInterscalene block Anaesthesia Post-operative analgesia a b s t r a c t Background: Shoulder arthroscopic surgeries have a high incidence of severe post-operative pain significant enough to interfere with recovery and rehabilitation. A regional anaesthetic technique combined with general anaesthesia reduces intra-operative requirements of anaesthesia and provides a better post-operative pain relief. As the commonly employed technique of interscalene brachial plexus block (ISB) is associated with potential serious complications, suprascapular nerve block (SSB) can be used as a safer alternative. Methods and material: In this prospective study, 60 ASA 1 or 2 adult patients undergoing shoulder arthroscopic surgery were randomised into two groups -ISB and SSB. In group ISB, ISB with 20 ml of 0.5% bupivacaine mixed with 75 mg clonidine was given. In the SSB group SSB was given with 15 ml of 0.5% bupivacaine with 75 mg clonidine. Pain was assessed using visual analogue scale and verbal pain scale scores and time to first rescue analgesia was noted. We used Student's t test and Chi-square/Fisher Exact test and used a statistical software to compare data. Results: In the present study, the mean duration of analgesia was 2.53 AE 2.26 h in SSB group compared to 7.23 AE 6.83 h in group ISB ( p value < 0.05). Overall rescue analgesic §

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“…When utilized for shoulder surgery, interscalene brachial plexus block has a success rate of between 82-97% [6,19,[75][76][77][78][79].…”

Section: Complications Of Interscalene Brachial Plexus Blockmentioning

confidence: 99%

Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia

Ghaleb¹,

Dilley²

2012

TOATJ

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A review of the literature regarding anesthesia for shoulder surgery was performed. Current anesthetic techniques available include regional, general, or a combination of regional and general. We discuss each of these techniques, with an emphasis on regional (specifically interscalene block), in detail. Current evidence supports both regional and general anesthesia to be safe and efficient techniques. The interscalene block is considered by most to provide the best surgical anesthesia and is the most commonly performed block for shoulder surgery. This paper aims to review the performance of the interscalene block and to discuss alternative choices for shoulder surgery, namely general anesthesia and a combined general/regional technique. We also aim to provide considerations to aid in the performance of a safely administered anesthetic.

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Interscalene Block Anesthesia for Shoulder Surgery

Cited by 61 publications

References 0 publications

Increased body mass index and ASA physical status IV are risk factors for block failure in ambulatory surgery — an analysis of 9,342 blocks

Increased body mass index and ASA physical status IV are risk factors for block failure in ambulatory surgery — an analysis of 9,342 blocks

Clinical evaluation of post-operative analgesia comparing suprascapular nerve block and interscalene brachial plexus block in patients undergoing shoulder arthroscopic surgery

Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia

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