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Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study
A combined cervical plexus and costoclavicular block provides effective shoulder analgesia without the risk of hemidiaphragmatic paralysis. However, whether this technique can also provide effective anesthesia for shoulder surgery remains unknown. Therefore, this study aimed to assess the feasibilit...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381335/ https://www.ncbi.nlm.nih.gov/pubmed/37511691 http://dx.doi.org/10.3390/jpm13071080 |
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author | Han, Jeong Uk Yang, Chunwoo Song, Jang-Ho Park, Jisung Choo, Hyeonju Lee, Taeil |
author_facet | Han, Jeong Uk Yang, Chunwoo Song, Jang-Ho Park, Jisung Choo, Hyeonju Lee, Taeil |
author_sort | Han, Jeong Uk |
collection | PubMed |
description | A combined cervical plexus and costoclavicular block provides effective shoulder analgesia without the risk of hemidiaphragmatic paralysis. However, whether this technique can also provide effective anesthesia for shoulder surgery remains unknown. Therefore, this study aimed to assess the feasibility and adverse effects of combined blocks in arthroscopic shoulder surgery. Fifty patients scheduled for arthroscopic shoulder surgery were prospectively enrolled. Intermediate cervical plexus (5 mL of 0.5% ropivacaine) and costoclavicular (20 mL of 0.5% ropivacaine) blocks were administered under ultrasound guidance. The block procedure time, needle pass, patient discomfort, anesthesia quality, onset time, postoperative analgesia quality, adverse events, and patient satisfaction were assessed. Surgical and block success were achieved in 45 (90%; 95% confidence interval [CI], 78–97%) and 44 (88%; 95% CI, 76–95%) patients, respectively. Three patients required local anesthetic supplementation, and two required general anesthesia. The incidence of hemidiaphragmatic paralysis was 12.0% (95% CI, 4.5–24.3%). Postoperative pain control was effective for the first 24 h postoperative. Neurological deficits were not observed. The patients reported a high level of satisfaction. This study revealed that a combined cervical plexus and costoclavicular block provided effective surgical anesthesia for arthroscopic shoulder surgery with a 12% incidence of hemidiaphragmatic paralysis. Further randomized studies comparing this technique with interscalene block are required. |
format | Online Article Text |
id | pubmed-10381335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103813352023-07-29 Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study Han, Jeong Uk Yang, Chunwoo Song, Jang-Ho Park, Jisung Choo, Hyeonju Lee, Taeil J Pers Med Brief Report A combined cervical plexus and costoclavicular block provides effective shoulder analgesia without the risk of hemidiaphragmatic paralysis. However, whether this technique can also provide effective anesthesia for shoulder surgery remains unknown. Therefore, this study aimed to assess the feasibility and adverse effects of combined blocks in arthroscopic shoulder surgery. Fifty patients scheduled for arthroscopic shoulder surgery were prospectively enrolled. Intermediate cervical plexus (5 mL of 0.5% ropivacaine) and costoclavicular (20 mL of 0.5% ropivacaine) blocks were administered under ultrasound guidance. The block procedure time, needle pass, patient discomfort, anesthesia quality, onset time, postoperative analgesia quality, adverse events, and patient satisfaction were assessed. Surgical and block success were achieved in 45 (90%; 95% confidence interval [CI], 78–97%) and 44 (88%; 95% CI, 76–95%) patients, respectively. Three patients required local anesthetic supplementation, and two required general anesthesia. The incidence of hemidiaphragmatic paralysis was 12.0% (95% CI, 4.5–24.3%). Postoperative pain control was effective for the first 24 h postoperative. Neurological deficits were not observed. The patients reported a high level of satisfaction. This study revealed that a combined cervical plexus and costoclavicular block provided effective surgical anesthesia for arthroscopic shoulder surgery with a 12% incidence of hemidiaphragmatic paralysis. Further randomized studies comparing this technique with interscalene block are required. MDPI 2023-06-29 /pmc/articles/PMC10381335/ /pubmed/37511691 http://dx.doi.org/10.3390/jpm13071080 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Brief Report Han, Jeong Uk Yang, Chunwoo Song, Jang-Ho Park, Jisung Choo, Hyeonju Lee, Taeil Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study |
title | Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study |
title_full | Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study |
title_fullStr | Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study |
title_full_unstemmed | Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study |
title_short | Combined Intermediate Cervical Plexus and Costoclavicular Block for Arthroscopic Shoulder Surgery: A Prospective Feasibility Study |
title_sort | combined intermediate cervical plexus and costoclavicular block for arthroscopic shoulder surgery: a prospective feasibility study |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381335/ https://www.ncbi.nlm.nih.gov/pubmed/37511691 http://dx.doi.org/10.3390/jpm13071080 |
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