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Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series

Interscalene block (ISB) is considered a gold standard regional anesthesia technique for shoulder surgery. Conventionally, 20 ml of local anesthetic is used for ISB. Nevertheless, this high-volume traditional ISB is associated with a high incidence of hemidiaphragmatic paresis due to phrenic nerve b...

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Autores principales: Diwan, Sandeep, Sethi, Divya, Kamath, Nilesh, Nair, Abhijit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944358/
https://www.ncbi.nlm.nih.gov/pubmed/35340964
http://dx.doi.org/10.4103/joacp.JOACP_438_20
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author Diwan, Sandeep
Sethi, Divya
Kamath, Nilesh
Nair, Abhijit
author_facet Diwan, Sandeep
Sethi, Divya
Kamath, Nilesh
Nair, Abhijit
author_sort Diwan, Sandeep
collection PubMed
description Interscalene block (ISB) is considered a gold standard regional anesthesia technique for shoulder surgery. Conventionally, 20 ml of local anesthetic is used for ISB. Nevertheless, this high-volume traditional ISB is associated with a high incidence of hemidiaphragmatic paresis due to phrenic nerve block. Recent evidence suggests that low-volume ultrasound-guided (USG)-ISB can provide effective analgesia whilst avoiding complications. Thirty patients of American Society of Anaesthesiologist ASA status I/II undergoing arthroscopic rotator cuff repair surgery under general anesthesia were administered low-volume USG-ISB and supraclavicular nerve block (SCNB). The block provided effective analgesia in 90% (27/30) of the patients as their visual analog score was below 4 at all times in the 24-h postoperative period. Only three patients required a single dose of rescue analgesic (diclofenac 50 mg iv) in the 24-h postoperative period. In postoperative recovery, two patients (6.67%) had desaturation due to hemidiaphragmatic paresis and three patients (10%) had a transient neurological deficit. In conclusion, low-volume USG-ISB with SCNB provides effective analgesia for arthroscopic rotator cuff repair surgery. The advantages of this technique include a low incidence of respiratory and neurological complications.
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spelling pubmed-89443582022-03-25 Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series Diwan, Sandeep Sethi, Divya Kamath, Nilesh Nair, Abhijit J Anaesthesiol Clin Pharmacol Case Series Interscalene block (ISB) is considered a gold standard regional anesthesia technique for shoulder surgery. Conventionally, 20 ml of local anesthetic is used for ISB. Nevertheless, this high-volume traditional ISB is associated with a high incidence of hemidiaphragmatic paresis due to phrenic nerve block. Recent evidence suggests that low-volume ultrasound-guided (USG)-ISB can provide effective analgesia whilst avoiding complications. Thirty patients of American Society of Anaesthesiologist ASA status I/II undergoing arthroscopic rotator cuff repair surgery under general anesthesia were administered low-volume USG-ISB and supraclavicular nerve block (SCNB). The block provided effective analgesia in 90% (27/30) of the patients as their visual analog score was below 4 at all times in the 24-h postoperative period. Only three patients required a single dose of rescue analgesic (diclofenac 50 mg iv) in the 24-h postoperative period. In postoperative recovery, two patients (6.67%) had desaturation due to hemidiaphragmatic paresis and three patients (10%) had a transient neurological deficit. In conclusion, low-volume USG-ISB with SCNB provides effective analgesia for arthroscopic rotator cuff repair surgery. The advantages of this technique include a low incidence of respiratory and neurological complications. Wolters Kluwer - Medknow 2021 2022-01-06 /pmc/articles/PMC8944358/ /pubmed/35340964 http://dx.doi.org/10.4103/joacp.JOACP_438_20 Text en Copyright: © 2022 Journal of Anaesthesiology Clinical Pharmacology 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 Series
Diwan, Sandeep
Sethi, Divya
Kamath, Nilesh
Nair, Abhijit
Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series
title Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series
title_full Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series
title_fullStr Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series
title_full_unstemmed Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series
title_short Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series
title_sort low-volume c5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944358/
https://www.ncbi.nlm.nih.gov/pubmed/35340964
http://dx.doi.org/10.4103/joacp.JOACP_438_20
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