Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach
Background: Brachial plexus catheter placement at the interscalene level is beneficial for shoulder analgesia but presents logistical challenges due to the superficial nature of the plexus at this level, increased patient movement in the neck, and therefore higher likelihood for catheter dislodgemen...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323002840 |
| _version_ | 1797296205656489984 |
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| author | Amy He, MD Kathryn S. Handlogten, MD Benjamin T. Kor, MD Michael J. Brown, MD Bassem T. Elhassan, MD Timothy B. Curry, MD, PhD Todd M. Kor, MD Thomas M. Stewart, MD |
| author_facet | Amy He, MD Kathryn S. Handlogten, MD Benjamin T. Kor, MD Michael J. Brown, MD Bassem T. Elhassan, MD Timothy B. Curry, MD, PhD Todd M. Kor, MD Thomas M. Stewart, MD |
| author_sort | Amy He, MD |
| collection | DOAJ |
| description | Background: Brachial plexus catheter placement at the interscalene level is beneficial for shoulder analgesia but presents logistical challenges due to the superficial nature of the plexus at this level, increased patient movement in the neck, and therefore higher likelihood for catheter dislodgement. Methods: Patients requiring shoulder arthroscopy and suprascapular nerve decompression were identified. Under arthroscopic guidance, a catheter was placed percutaneously into the scalene medius muscle next to the suprascapular nerve and the upper trunk of the brachial plexus. Patients were followed postoperatively for perioperative analgesic outcomes. Results: Ten patients were identified and consented for intraoperative brachial plexus catheter placement. Patient demographics and surgical details were determined. Postoperative adjunctive pain management and pain scores were variable. Two patients required catheter replacement using ultrasound guidance in the perioperative anesthesia care unit due to poorly controlled pain. There were no incidents of catheter failure due to dislodgement. Discussion: This study presents the first description of arthroscopically-assisted brachial plexus catheter placement. This method may present an alternative to traditional ultrasound guided interscalene catheter placement. Further study is needed to determine if analgesic outcomes, block success, and dislodgement rates are improved with this method. |
| first_indexed | 2024-03-07T22:00:00Z |
| format | Article |
| id | doaj.art-5ac42313ae4f4b8d8a6a772efc09a119 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-07T22:00:00Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-5ac42313ae4f4b8d8a6a772efc09a1192024-02-24T04:55:38ZengElsevierJSES International2666-63832024-03-0182310316Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approachAmy He, MD0Kathryn S. Handlogten, MD1Benjamin T. Kor, MD2Michael J. Brown, MD3Bassem T. Elhassan, MD4Timothy B. Curry, MD, PhD5Todd M. Kor, MD6Thomas M. Stewart, MD7Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USADepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USADepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USADepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USADepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USADepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA; Corresponding author: Thomas M. Stewart, MD, Department of Anesthesiology, Mayo Cliniç 200 First Street SW, Rochester, MN 55905, USA.Background: Brachial plexus catheter placement at the interscalene level is beneficial for shoulder analgesia but presents logistical challenges due to the superficial nature of the plexus at this level, increased patient movement in the neck, and therefore higher likelihood for catheter dislodgement. Methods: Patients requiring shoulder arthroscopy and suprascapular nerve decompression were identified. Under arthroscopic guidance, a catheter was placed percutaneously into the scalene medius muscle next to the suprascapular nerve and the upper trunk of the brachial plexus. Patients were followed postoperatively for perioperative analgesic outcomes. Results: Ten patients were identified and consented for intraoperative brachial plexus catheter placement. Patient demographics and surgical details were determined. Postoperative adjunctive pain management and pain scores were variable. Two patients required catheter replacement using ultrasound guidance in the perioperative anesthesia care unit due to poorly controlled pain. There were no incidents of catheter failure due to dislodgement. Discussion: This study presents the first description of arthroscopically-assisted brachial plexus catheter placement. This method may present an alternative to traditional ultrasound guided interscalene catheter placement. Further study is needed to determine if analgesic outcomes, block success, and dislodgement rates are improved with this method.http://www.sciencedirect.com/science/article/pii/S2666638323002840ArthroscopySuprascapular nerve decompressionBrachial plexus catheterInterscalene blockPain managementAnalgesia |
| spellingShingle | Amy He, MD Kathryn S. Handlogten, MD Benjamin T. Kor, MD Michael J. Brown, MD Bassem T. Elhassan, MD Timothy B. Curry, MD, PhD Todd M. Kor, MD Thomas M. Stewart, MD Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach JSES International Arthroscopy Suprascapular nerve decompression Brachial plexus catheter Interscalene block Pain management Analgesia |
| title | Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach |
| title_full | Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach |
| title_fullStr | Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach |
| title_full_unstemmed | Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach |
| title_short | Arthroscopic assisted brachial plexus catheter placement: an alternative to the percutaneous interscalene approach |
| title_sort | arthroscopic assisted brachial plexus catheter placement an alternative to the percutaneous interscalene approach |
| topic | Arthroscopy Suprascapular nerve decompression Brachial plexus catheter Interscalene block Pain management Analgesia |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323002840 |
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