Abstract:A continuous suprascapular block may be a useful analgesic alternative to the interscalene or supraclavicular approaches when the preservation of lung function is a priority after shoulder replacement surgery.
“…Horner's syndrome can occur as a result of paralysis of the ipsilateral sympathetic cervical chain by the local anesthetic and is mainly associated with ISBB and SCBB . Most of the studies that have compared ISBB with SCBB reported that Horner's syndrome developed more frequently in ISBB than in SCBB . In our study, Horner's syndrome occurred significantly more frequently in the IB group than in the SB group.…”
Background
The interscalene brachial plexus block (ISBB) is an effective procedure for minimizing postoperative opioid consumption and pain following arthroscopic shoulder surgery. The ultrasound (US)‐guided supraclavicular brachial plexus block (SCBB) seems to be an alternative technique for arthroscopic shoulder surgery. However, evidence is lacking regarding the impact of SCBB on postoperative pain management and recovery after arthroscopic shoulder surgery. The aim of this study was to compare the effects of SCBB with ISBB in terms of postoperative pain and quality of recovery after arthroscopic shoulder surgery.
Methods
A total of 62 adult patients scheduled for arthroscopic shoulder surgery under general anesthesia were randomized into 2 groups to receive either ISBB (IB group, n = 31) or SCBB (SB group, n = 29) with 20 mL of 0.25% bupivacaine under US guidance. Assessments included postoperative pain scores, additional analgesic requirement, timing of the first analgesic requirement, Quality of Recovery‐40 (QoR‐40) scores, block characteristics, and side effects.
Results
No significant differences were found between the 2 groups for pain scores (P = 0.34), timing of first analgesic requirement (P = 0.30), additional analgesic requirement (P = 0.34), or QoR‐40 scores (P = 0.13). The block characteristics regarding procedure time (P = 0.95), block failure, and onset time of sensory blockade (P = 0.33) were similar. Horner's syndrome occurred in 8 patients in the IB group and 1 patient in the SB group (P = 0.015).
Conclusions
This study showed that US‐guided SCBB is as effective as ISBB in reducing postoperative pain and improving the quality of recovery for arthroscopic shoulder surgery.
“…Horner's syndrome can occur as a result of paralysis of the ipsilateral sympathetic cervical chain by the local anesthetic and is mainly associated with ISBB and SCBB . Most of the studies that have compared ISBB with SCBB reported that Horner's syndrome developed more frequently in ISBB than in SCBB . In our study, Horner's syndrome occurred significantly more frequently in the IB group than in the SB group.…”
Background
The interscalene brachial plexus block (ISBB) is an effective procedure for minimizing postoperative opioid consumption and pain following arthroscopic shoulder surgery. The ultrasound (US)‐guided supraclavicular brachial plexus block (SCBB) seems to be an alternative technique for arthroscopic shoulder surgery. However, evidence is lacking regarding the impact of SCBB on postoperative pain management and recovery after arthroscopic shoulder surgery. The aim of this study was to compare the effects of SCBB with ISBB in terms of postoperative pain and quality of recovery after arthroscopic shoulder surgery.
Methods
A total of 62 adult patients scheduled for arthroscopic shoulder surgery under general anesthesia were randomized into 2 groups to receive either ISBB (IB group, n = 31) or SCBB (SB group, n = 29) with 20 mL of 0.25% bupivacaine under US guidance. Assessments included postoperative pain scores, additional analgesic requirement, timing of the first analgesic requirement, Quality of Recovery‐40 (QoR‐40) scores, block characteristics, and side effects.
Results
No significant differences were found between the 2 groups for pain scores (P = 0.34), timing of first analgesic requirement (P = 0.30), additional analgesic requirement (P = 0.34), or QoR‐40 scores (P = 0.13). The block characteristics regarding procedure time (P = 0.95), block failure, and onset time of sensory blockade (P = 0.33) were similar. Horner's syndrome occurred in 8 patients in the IB group and 1 patient in the SB group (P = 0.015).
Conclusions
This study showed that US‐guided SCBB is as effective as ISBB in reducing postoperative pain and improving the quality of recovery for arthroscopic shoulder surgery.
“…Prior studies have used normal saline in the placement of continuous perineural catheters in order to best isolate the effect of the continuous infusion only. 32 However, our prior successful outcomes using continuous ACBs for postoperative TKA analgesia mandated the use of this technique per hospital standard practice by our institutional review board. 3 Third, although all continuous perineural catheters were evaluated each day for displacement at the skin, saphenous nerve sensory testing was not routinely performed in every subject as part of the study methods.…”
“…Beside axillary/suprascapular 2,3 and infraclavicular/suprascapular nerve blocks, 4 proposed strategies also include isolated suprascapular nerve blocks. 19,20 Although recent trials by Wiegel et al 19 and Auyong et al 20 have concluded that suprascapular blocks result in similar analgesia to ISB for arthroscopic shoulder surgery 19 and shoulder arthroplasty, 20 other studies seem to suggest that they provide suboptimal analgesia. 21,22 Because the shoulder also receives sensory innervation from the axillary, lateral pectoral, and subscapular nerves, 1 we decided to err on the side of caution and attempted to find an alternative to ISB that would anesthetize all these nerves.…”
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