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Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery

BACKGROUND: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after pl...

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Autores principales: Shin, Hyeon Ju, Ahn, Jae Hyun, Jung, Hye In, Lim, Choon Hak, Shin, Hye Won, Lee, Hye Won, Lim, Hae Ja, Yoon, Suk Min, Chang, Seong Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Anesthesiologists 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249569/
https://www.ncbi.nlm.nih.gov/pubmed/22220224
http://dx.doi.org/10.4097/kjae.2011.61.6.475
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author Shin, Hyeon Ju
Ahn, Jae Hyun
Jung, Hye In
Lim, Choon Hak
Shin, Hye Won
Lee, Hye Won
Lim, Hae Ja
Yoon, Suk Min
Chang, Seong Ho
author_facet Shin, Hyeon Ju
Ahn, Jae Hyun
Jung, Hye In
Lim, Choon Hak
Shin, Hye Won
Lee, Hye Won
Lim, Hae Ja
Yoon, Suk Min
Chang, Seong Ho
author_sort Shin, Hyeon Ju
collection PubMed
description BACKGROUND: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after placement of the catheter. METHODS: Forty-two patients undergoing elective arthroscopic shoulder surgery were included in this study and an interscalene catheter was inserted under the guidance of ultrasound with posterior approach. With the inplane approach, the 17 G Tuohy needle was advanced until the tip was placed between the C5 and C6 nerve roots. After a bolus injection of 20 ml of 0.2% ropivacaine, a catheter was threaded and secured. A continuous infusion of ropivacaine 0.2% 4 ml/hr with patient-controlled 5 ml boluses every hour was used over 2 days. Difficulties in placement of the catheter, clinical efficacy of analgesia and complications were recorded. All patients were monitored for 48 hours and examined by the surgeon for complications within 2 weeks of hospital discharge. RESULTS: Easy placement of the catheter was achieved in 100% of the patients and the success rate of catheter placement during the 48 hr period was 92.9%. Postoperative analgesia was effective in 88.1% of the patients in the post anesthetic care unit. The major complications included nausea (7.1%), vomiting (4.8%), dyspnea (4.8%) and unintended vascular punctures (2.4%). Other complications such as neurologic deficits and local infection around the puncture site did not occur. CONCLUSIONS: The ultrasound-guided interscalene block with a posterior approach is associated with a success high rate in placement of the interscalene catheter and a low rate of complications. However, the small sample size limits us to draw definite conclusions. Therefore, a well-designed randomized controlled trial is required to confirm our preliminary study.
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spelling pubmed-32495692012-01-04 Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery Shin, Hyeon Ju Ahn, Jae Hyun Jung, Hye In Lim, Choon Hak Shin, Hye Won Lee, Hye Won Lim, Hae Ja Yoon, Suk Min Chang, Seong Ho Korean J Anesthesiol Clinical Research Article BACKGROUND: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after placement of the catheter. METHODS: Forty-two patients undergoing elective arthroscopic shoulder surgery were included in this study and an interscalene catheter was inserted under the guidance of ultrasound with posterior approach. With the inplane approach, the 17 G Tuohy needle was advanced until the tip was placed between the C5 and C6 nerve roots. After a bolus injection of 20 ml of 0.2% ropivacaine, a catheter was threaded and secured. A continuous infusion of ropivacaine 0.2% 4 ml/hr with patient-controlled 5 ml boluses every hour was used over 2 days. Difficulties in placement of the catheter, clinical efficacy of analgesia and complications were recorded. All patients were monitored for 48 hours and examined by the surgeon for complications within 2 weeks of hospital discharge. RESULTS: Easy placement of the catheter was achieved in 100% of the patients and the success rate of catheter placement during the 48 hr period was 92.9%. Postoperative analgesia was effective in 88.1% of the patients in the post anesthetic care unit. The major complications included nausea (7.1%), vomiting (4.8%), dyspnea (4.8%) and unintended vascular punctures (2.4%). Other complications such as neurologic deficits and local infection around the puncture site did not occur. CONCLUSIONS: The ultrasound-guided interscalene block with a posterior approach is associated with a success high rate in placement of the interscalene catheter and a low rate of complications. However, the small sample size limits us to draw definite conclusions. Therefore, a well-designed randomized controlled trial is required to confirm our preliminary study. The Korean Society of Anesthesiologists 2011-12 2011-12-20 /pmc/articles/PMC3249569/ /pubmed/22220224 http://dx.doi.org/10.4097/kjae.2011.61.6.475 Text en Copyright © the Korean Society of Anesthesiologists, 2011 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Shin, Hyeon Ju
Ahn, Jae Hyun
Jung, Hye In
Lim, Choon Hak
Shin, Hye Won
Lee, Hye Won
Lim, Hae Ja
Yoon, Suk Min
Chang, Seong Ho
Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
title Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
title_full Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
title_fullStr Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
title_full_unstemmed Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
title_short Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
title_sort feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249569/
https://www.ncbi.nlm.nih.gov/pubmed/22220224
http://dx.doi.org/10.4097/kjae.2011.61.6.475
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