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...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2021;volume=37;issue=4;spage=661;epage=664;aulast=Diwan |
| _version_ | 1818083451831582720 |
|---|---|
| author | Sandeep Diwan Divya Sethi Nilesh Kamath Abhijit Nair |
| author_facet | Sandeep Diwan Divya Sethi Nilesh Kamath Abhijit Nair |
| author_sort | Sandeep Diwan |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-10T19:38:13Z |
| format | Article |
| id | doaj.art-6ee9d5d514c1484cacc42b601ac2f7fe |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-12-10T19:38:13Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-6ee9d5d514c1484cacc42b601ac2f7fe2022-12-22T01:36:03ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852021-01-0137466166410.4103/joacp.JOACP_438_20Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case seriesSandeep DiwanDivya SethiNilesh KamathAbhijit NairInterscalene 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.http://www.joacp.org/article.asp?issn=0970-9185;year=2021;volume=37;issue=4;spage=661;epage=664;aulast=Diwananaesthesiaankylosing spondylitiscaudal anaesthesiaanalgesiaarthroscopyinterscalene blockpostoperativeultrasound |
| spellingShingle | Sandeep Diwan Divya Sethi Nilesh Kamath Abhijit Nair Low-volume C5–6 interscalene and supraclavicular nerve blocks for arthroscopic shoulder surgery: A case series Journal of Anaesthesiology Clinical Pharmacology anaesthesia ankylosing spondylitis caudal anaesthesiaanalgesia arthroscopy interscalene block postoperative ultrasound |
| 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 | anaesthesia ankylosing spondylitis caudal anaesthesiaanalgesia arthroscopy interscalene block postoperative ultrasound |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2021;volume=37;issue=4;spage=661;epage=664;aulast=Diwan |
| work_keys_str_mv | AT sandeepdiwan lowvolumec56interscaleneandsupraclavicularnerveblocksforarthroscopicshouldersurgeryacaseseries AT divyasethi lowvolumec56interscaleneandsupraclavicularnerveblocksforarthroscopicshouldersurgeryacaseseries AT nileshkamath lowvolumec56interscaleneandsupraclavicularnerveblocksforarthroscopicshouldersurgeryacaseseries AT abhijitnair lowvolumec56interscaleneandsupraclavicularnerveblocksforarthroscopicshouldersurgeryacaseseries |