Randomized, controlled trial comparing respiratory and analgesic effects of interscalene, anterior suprascapular, and posterior suprascapular nerve blocks for arthroscopic shoulder surgery.

Korean journal of anesthesiology
Yean Chin LimQian Jun Tong

Abstract

Interscalene brachial plexus block (ISB) provides excellent analgesia for arthroscopic shoulder surgeries but is associated with adverse effects including hemidiaphragmatic paresis. We aimed to compare the respiratory effects, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) between suprascapular nerve block (SSB) and ISB. Sixty patients were recruited and randomized into ISB, anterior SSB, and posterior SSB groups. FVC, FEV1, and diaphragmatic excursion were evaluated at baseline and 30 minutes after intervention. Blocks were performed under ultrasound guidance with 15 ml of 0.5% ropivacaine. Pain scores were assessed at 6, 12, and 24 hours postoperatively. The ISB group showed a reduced FVC of 31.2% ± 17.5% (mean ± SD), while the anterior and posterior SSB groups had less reduction of 3.6% ± 18.6% and 6.8% ± 6.5%, respectively (P < 0.001). The ISB group showed more reduction in diaphragmatic excursion than the anterior and posterior SSB groups (median [IQR]): -85.7% (-95.3% to -63.3%) vs. -1.8% (-13.1% to 2.3%) and -1.2% (-8.8% to 16.8%), respectively (P < 0.001). The median pain scores (IQR) in the ISB and anterior SSB groups were lower than those in the posterior SSB group at 6 hours on movement:...Continue Reading

References

Sep 1, 1996·Clinical Orthopaedics and Related Research·O C AszmannE G McFarland
Nov 19, 2009·Regional Anesthesia and Pain Medicine·Steven H RenesGeert J van Geffen
Jan 10, 2012·Regional Anesthesia and Pain Medicine·Andreas SiegenthalerUrs Eichenberger
Jan 18, 2012·Revista brasileira de anestesiologia·Marcos Rassi FernandesGilson Cassem Ramos
Mar 22, 2012·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Sang Mook LeeJang-Su Park
Feb 6, 2013·Muscle & Nerve·Aarti SarwalMichael S Cartwright
Sep 24, 2015·International Journal of Chronic Obstructive Pulmonary Disease·Nadine ScheibeAndreas Bastian

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sedation

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NCT03277326

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