Peripheral Nerve Injury Following Interscalene Blocks: A Systematic Review to Guide Orthopedic Surgeons

Holbrook, Hayden S; Parker, Benjamin R.

doi:10.3928/01477447-20180815-04

Cited by 11 publications

(9 citation statements)

References 86 publications

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“…The use of anesthetics relieves discomfort in patients during operation, but extensive application of anesthetics can cause damage to the nervous system. However, increasing evidence has shown that excessive use of anesthetics can lead to damage in the nervous system (Holbrook & Parker, 2018; Kitagawa et al., 2004). Isoflurane is a traditional anesthetic.…”

Section: Discussionmentioning

confidence: 99%

Atractylenolide III alleviates isoflurane‐induced injury in rat hippocampal neurons by activating the PI3K/Akt/mTOR pathway

Zhu

Wang

et al. 2021

J Food Biochem

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The use of anesthetics relieves discomfort in patients during operation, but extensive application of anesthetics can cause damage to the nervous system. Atractylenolide III (ATL‐III) is an active ingredient derived from Baizhu, which is a kind of traditional Chinese medicines. Recent studies have shown that ATL‐III alleviates inflammation and oxidative stress in various tissues by regulating the PI3K/Akt/mTOR signaling pathway. However, whether or not the application of ATL‐III could relieve isoflurane‐induced damage in rat hippocampal neurons remains unclear. In this study, rats were stimulated with isoflurane and treated with ATL‐III (intragastric administration) simultaneously. After rats were sacrificed, apoptosis and autophagy in the hippocampal neurons were assessed using TUNEL assays and western blotting, respectively. Then, the expression of inflammatory factors was determined by q‐PCR and ELISA. The levels of p‐PI3K, p‐Akt, and p‐mTOR were quantified by western blotting. We found that ATL‐III relieved isoflurane‐induced apoptosis, autophagy and inflammation in hippocampal neurons in rats. ATL‐III treatment also inhibited the expression of TNF‐α, IL‐1β, and IL‐6 in these cells. Furthermore, ATL‐III promoted the expression of p‐PI3K, p‐Akt, and p‐mTOR in the hippocampal neurons. All these results indicated that ATL‐III alleviated isoflurane‐induced injury in rat hippocampal neurons by activating the PI3K/Akt/mTOR signaling pathway. Practical applications Whether or not Atractylenolide III (ATL‐III) could alleviate neurotoxicity induced by anesthetics is unclear. In this study, we investigated the effect of ATL‐III on anesthetic‐induced nervous system damage. The findings from this study could also provide a novel therapy for the treatment of patients with anesthetic‐induced nerve injury.

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Section: Discussionmentioning

confidence: 99%

Atractylenolide III alleviates isoflurane‐induced injury in rat hippocampal neurons by activating the PI3K/Akt/mTOR pathway

Zhu

Wang

et al. 2021

J Food Biochem

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“…Studies were excluded if RA was administered via a continuous catheter infusion (vs injected boluses), as the use of catheters in brachial plexus blockade has been associated with a higher incidence of neurologic injuries. 22 Finally, studies were excluded if RA was performed in the emergency department or if surgery was performed outside the operating room, because of the unique challenges of those environments.…”

Section: Methodsmentioning

confidence: 99%

Peripheral Nerve Injury After Upper-Extremity Surgery Performed Under Regional Anesthesia: A Systematic Review

Silverstein

Tevlin

Higgins

et al. 2022

Journal of Hand Surgery Global Online

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“…116 Studies estimate that the frequency of nerve injuries can be as high as 3% to 5%, with the highest incidence associated with upper extremity interscalene blocks. 59 As orthopaedic surgeons are responsible for their patients' overall care, knowledge of these pain control strategies is imperative. The following review outlines the most commonly used PNBs that are currently available for both hip and knee arthroscopic procedures to better inform our sports medicine community in the fight to decrease opioid use after surgery.…”

mentioning

confidence: 99%

“…116 Studies estimate that the frequency of nerve injuries can be as high as 3% to 5%, with the highest incidence associated with upper extremity interscalene blocks. 59…”

mentioning

confidence: 99%

A Practical Guide to Lower Extremity Nerve Blocks for the Sports Medicine Surgeon

et al. 2022

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Background: Peripheral nerve blocks (PNBs) are vital in the administration of surgical analgesia and have grown in popularity for use in lower extremity arthroscopic procedures because of their capacity to safely and effectively control pain. The number and specificity of PNBs, however, have made choosing the best option for a procedure nebulous for orthopaedic surgeons. Purpose: To present a narrative literature review of the PNBs available for arthroscopic hip and knee procedures that is adapted to an audience of orthopaedic surgeons. Study Design: Narrative literature review. Methods: A combination of the names of various lower extremity PNBs AND “hip arthroscopy” OR “knee arthroscopy” was used to search the English medical literature including PubMed, Cochrane Library, ScienceDirect, Embase, and Scopus. Placement technique, specificity of blockade, efficacy, and complications were assessed. Searches were performed through May 2, 2021. Results: A total of 157 studies were included in this review of lower extremity PNBs. Femoral nerve, lumbar plexus, sciatic nerve, and fascia iliaca compartment blocks were most commonly used in arthroscopic hip surgery, while femoral nerve, 3-in-1, and adductor canal blocks were preferred for arthroscopic knee surgery. Each block demonstrated a significant benefit ( P > .05) in ≥1 of the following outcomes: intraoperative morphine, pain scores, nausea, and/or opioid consumption. Combination blocks including the lateral femoral cutaneous nerve block, obturator nerve block, quadratus lumborum block, and L1 and L2 paravertebral block have also been described. Complication rates ranged from 0% to 4.8% in those administered with ultrasound guidance. The most commonly reported complications included muscular weakness, postoperative falls, neuropathy, intravascular and intraneural injections, and hematomas. Conclusion: When administered properly, PNBs were a safe and effective adjuvant method of pain control with a significant potential to limit postoperative narcotic use. While blockade choice varies by surgeon preference and procedure, all PNBs should be administered with ultrasound guidance, and vigilant protocols for the risk of postoperative falls should be exercised in patients who receive them.

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Peripheral Nerve Injury Following Interscalene Blocks: A Systematic Review to Guide Orthopedic Surgeons

Cited by 11 publications

References 86 publications

Atractylenolide III alleviates isoflurane‐induced injury in rat hippocampal neurons by activating the PI3K/Akt/mTOR pathway

Atractylenolide III alleviates isoflurane‐induced injury in rat hippocampal neurons by activating the PI3K/Akt/mTOR pathway

Peripheral Nerve Injury After Upper-Extremity Surgery Performed Under Regional Anesthesia: A Systematic Review

A Practical Guide to Lower Extremity Nerve Blocks for the Sports Medicine Surgeon

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