Cargando…
Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series
The brachial plexus blocks (BPBs) are routinely performed for all surgeries in the vicinity of the elbow joint. Phrenic nerve paresis is a major problem with above-clavicle blocks especially the interscalene approach. The primary aim of this pilot study was to assess feasibility and to evaluate if p...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077775/ https://www.ncbi.nlm.nih.gov/pubmed/37032670 http://dx.doi.org/10.4103/sja.sja_564_22 |
_version_ | 1785020377363120128 |
---|---|
author | Diwan, Sandeep Dongre, Himaunshu V. Nair, Abhijit S. Panchwagh, Suhrud |
author_facet | Diwan, Sandeep Dongre, Himaunshu V. Nair, Abhijit S. Panchwagh, Suhrud |
author_sort | Diwan, Sandeep |
collection | PubMed |
description | The brachial plexus blocks (BPBs) are routinely performed for all surgeries in the vicinity of the elbow joint. Phrenic nerve paresis is a major problem with above-clavicle blocks especially the interscalene approach. The primary aim of this pilot study was to assess feasibility and to evaluate if perioperative pain management with the articular and cutaneous nerve block, the peri-humeral block (PHB) resulted in decreased use of opioid consumption in the intraoperative and postoperative period for the first 24 hours. Twenty-four patients with distal humerus fracture received ultrasound (US)-guided PHB as part of their perioperative anesthetic management. The primary aim was to evaluate block efficacy in terms of time to first analgesia and opioid consumption in first 24 hours. US in real time revealed that in all patients the local anesthetic was optimally deposited. Due to a stable intraoperative hemodynamics, none of the patients required additional opioid doses. The median pain scores over 24 hours were 2.4 with IQR (0-3.8). The mean time to first analgesic was 425.417 ± 229.005 min. There were no adverse effects reported at the time of hospital discharge. Though the US-guided PHB would not replace the BPB, in some special circumstances, it would be desirable to implement the former block which has opioid and motor sparing features and incorporate with multimodal analgesia. |
format | Online Article Text |
id | pubmed-10077775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-100777752023-04-07 Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series Diwan, Sandeep Dongre, Himaunshu V. Nair, Abhijit S. Panchwagh, Suhrud Saudi J Anaesth Case Report The brachial plexus blocks (BPBs) are routinely performed for all surgeries in the vicinity of the elbow joint. Phrenic nerve paresis is a major problem with above-clavicle blocks especially the interscalene approach. The primary aim of this pilot study was to assess feasibility and to evaluate if perioperative pain management with the articular and cutaneous nerve block, the peri-humeral block (PHB) resulted in decreased use of opioid consumption in the intraoperative and postoperative period for the first 24 hours. Twenty-four patients with distal humerus fracture received ultrasound (US)-guided PHB as part of their perioperative anesthetic management. The primary aim was to evaluate block efficacy in terms of time to first analgesia and opioid consumption in first 24 hours. US in real time revealed that in all patients the local anesthetic was optimally deposited. Due to a stable intraoperative hemodynamics, none of the patients required additional opioid doses. The median pain scores over 24 hours were 2.4 with IQR (0-3.8). The mean time to first analgesic was 425.417 ± 229.005 min. There were no adverse effects reported at the time of hospital discharge. Though the US-guided PHB would not replace the BPB, in some special circumstances, it would be desirable to implement the former block which has opioid and motor sparing features and incorporate with multimodal analgesia. Wolters Kluwer - Medknow 2023 2023-01-02 /pmc/articles/PMC10077775/ /pubmed/37032670 http://dx.doi.org/10.4103/sja.sja_564_22 Text en Copyright: © 2023 Saudi Journal of Anesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Diwan, Sandeep Dongre, Himaunshu V. Nair, Abhijit S. Panchwagh, Suhrud Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series |
title | Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series |
title_full | Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series |
title_fullStr | Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series |
title_full_unstemmed | Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series |
title_short | Peri-humeral block for postoperative analgesia in patients with distal humerus surgery: A case series |
title_sort | peri-humeral block for postoperative analgesia in patients with distal humerus surgery: a case series |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077775/ https://www.ncbi.nlm.nih.gov/pubmed/37032670 http://dx.doi.org/10.4103/sja.sja_564_22 |
work_keys_str_mv | AT diwansandeep perihumeralblockforpostoperativeanalgesiainpatientswithdistalhumerussurgeryacaseseries AT dongrehimaunshuv perihumeralblockforpostoperativeanalgesiainpatientswithdistalhumerussurgeryacaseseries AT nairabhijits perihumeralblockforpostoperativeanalgesiainpatientswithdistalhumerussurgeryacaseseries AT panchwaghsuhrud perihumeralblockforpostoperativeanalgesiainpatientswithdistalhumerussurgeryacaseseries |