Risk factors for occurrence of failed interscalene brachial plexus blocks for shoulder arthroscopy using 20 mL 0.5% ropivacaine: a randomised trial

Stasiowski, Michał; Chabierska, Ewa; Marciniak, Radosław; Kolny, Michał; Zuber, Marek; Jałowiecki, Przemysław; Pluta, Aleksandra; Szumera, Izabela

doi:10.5603/ait.a2018.0030

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…However, local anesthetic infiltration might not always be effective because sometimes the exact pin sites might not match the infiltrated scalp area 1 . Moreover, scalp nerve block is not always effective 34 , and its performance required extra time and training 2 . Further research is necessary.…”

Section: Discussionmentioning

confidence: 99%

Predicting the optimal concentration of remifentanil for skull pin fixation with hemodynamic and analgesia nociception index monitoring

Kuo,

Chen,

Lieu

et al. 2024

Sci Rep

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Inadequate antinociception during skull pin fixation may cause hemodynamic instability in intracranial surgery. The optimal concentration of remifentanil to provide adequate antinociception and stable hemodynamics during skull pin fixation under analgesia nociception index monitoring is unknown. This study is to assess the 90% effective concentration of remifentanil for skull pin fixation under hemodynamic and analgesia nociception index monitoring. Twenty-six patients were enrolled for intracranial surgery, anesthesia was induced and maintained under total intravenous anesthesia using target-controlled infusion for remifentanil and propofol under analgesia nociception index and bispectral index monitoring. Skull pin fixation was performed at different effect-site concentrations of remifentanil required for Dixon's up-and-down method with a step size of 0.5 ng/ml under bispectral index 40–60. Inadequate antinociception is defined when either ANI < 30 or > 20% in hemodynamic changes from baseline (e.g. heart rate > 100 beats/min, or blood pressure > 180/100 mmHg) and the effect-site concentration of remifentanil is considered as failure. It is considered success as ANI > 30 and < 20% hemodynamic changes from baseline simultaneously. Seven pairs of failure/success were used for probit analysis. The 90% effective concentration of remifentanil for skull pin fixation with adequate antinociception and hemodynamic stability was 4.7 ng/ml.

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Section: Discussionmentioning

confidence: 99%

Predicting the optimal concentration of remifentanil for skull pin fixation with hemodynamic and analgesia nociception index monitoring

Kuo,

Chen,

Lieu

et al. 2024

Sci Rep

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show abstract

“…The rates of Horner's syndrome in the literature (adolescents to adults) range from 1.5% to 37.5%. 12 20 Stasiowski et al 20 suggests that a higher water concentration in the prevertebral space of younger patients might encourage local anaesthetic spread and increase their rates of Horner's syndrome. This is not reliably reproduced in the literature, likely because of high under-reporting rates and significant variability in dosing of local anaesthetics.…”

Section: Original Researchmentioning

confidence: 99%

Continuous interscalene catheters for ambulatory shoulder surgery provide effective intraoperative and early postoperative analgesia in adolescent patients

et al. 2020

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ObjectivesTo review the analgesic efficacy (by means of pain scores and opioid consumption) and adverse events after interscalene catheter (ISC) placement for ambulatory shoulder surgery in a series of adolescent patients.MethodsA retrospective review was performed of 36 patients who underwent ISC placement. Intraoperative and postoperative data regarding block placement, opioid consumption and pain scores were recorded. Via telephone, patients were assessed on postoperative days (PODs) 1-3 for pain scores, oxycodone use, global satisfaction and adverse effects of treatment.ResultsThe mean age was 15.4±1.8 years. The average time of ISC placement was 11.8±3.8 min. The mean postanaesthesia care unit maximum pain score was 1.6±2.4 with four patients who received rescue intravenous morphine. Mean pain scores for POD 1- 3 at rest were 2.5±2.3, 2.1±1.5 and 1.8±1.6, respectively. Mean number of doses of oxycodone on POD 1–3 were 1.1±1.4, 1.5±1.8 and 0.7±1.3, respectively. Satisfaction was reported in 94% of patients and 97% would have the catheter again. Adverse events included two accidental catheter removals at the end of the procedure or in the recovery unit, one catheter replacement at the end of surgery due to dislodgement, two early catheter removals on POD 2 because of dressing failure and insertion site discomfort, three cases of Horner’s Syndrome and one patient with transient ipsilateral facial numbness on POD 3.ConclusionThe use of ISCs in adolescent ambulatory shoulder surgery is beneficial, providing effective intraoperative and early postoperative analgesia as evidenced by low pain scores and minimal opioid use. Their routine use should be considered as they minimise perioperative opioid use with minimal adverse events.Level of evidenceLevel IV, case series.

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Risk factors for occurrence of failed interscalene brachial plexus blocks for shoulder arthroscopy using 20 mL 0.5% ropivacaine: a randomised trial

Abstract: In our study, patients received satisfactory analgesia in the post-operational period no matter what technique was used regardless of their age, gender or potentially uncommon anthropometry.

Cited by 2 publications

References 13 publications

Predicting the optimal concentration of remifentanil for skull pin fixation with hemodynamic and analgesia nociception index monitoring

Predicting the optimal concentration of remifentanil for skull pin fixation with hemodynamic and analgesia nociception index monitoring

Continuous interscalene catheters for ambulatory shoulder surgery provide effective intraoperative and early postoperative analgesia in adolescent patients

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