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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...

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Autores principales: Han, Jeong Uk, Yang, Chunwoo, Song, Jang-Ho, Park, Jisung, Choo, Hyeonju, Lee, Taeil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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