57Patient survey of continuous interscalene analgesia at home after shoulder surgery

Current Concepts in Anaesthesia for Shoulder Surgery

“…Klein et al reported logistical problems and inadequate analgesia in 47-70% of patients in their study group of ambulatory interscalene analgesia following open rotator cuff repair [59]. In a survey of 172 patients who had undergone CISB almost 10% complained of dyspnea [60]. Readmission for lower lobe collapse has been reported [61], as have infectious complications such as cellulitis and mediastinitis [62].…”

The catheter-over-needle assembly offers greater stability and less leakage compared with the traditional counterpart in continuous interscalene nerve blocks: a randomized patient-blinded study

“…Other data, including block performance time and pain scores, are provided in the Table. Continuous peripheral nerve blocks are performed routinely with CTN catheters, and it is acknowledged in the literature that leakage at the catheter insertion site is a common complication with continuous interscalene blocks. 1,4 The results of our randomized study suggest that interscalene CON catheters are clinically less prone to leakage compared with traditional CTN catheters. This is especially apparent given that all patients who received a CTN catheter experienced leakage compared with none of the patients who received a CON catheter.…”

“…A prior study of complications of continuous interscalene analgesia showed a 9.3% incidence of leakage at the catheter site. 1 We conducted a prospective randomized study to test the hypothesis that interscalene catheter-over-needle (CON) assemblies are clinically less prone to leakage at the insertion site compared with conventional catheterthrough-needle (CTN) counterparts. The primary outcome of the study was leakage from the catheter insertion site.…”

The effect of continuous interscalene brachial plexus block with 0.125% bupivacaine vs 0.2% ropivacaine on pain relief, diaphragmatic motility, and ventilatory function

“…The enrolled patients had significant changes in pulmonary function but no symptomatic shortness of breath. The absence of symptoms is due to the exclusion criteria because about 9% of patients in the general population complain of shortness of breath with interscalene CPNBH [13]. It is for these patients that we need to find a safer solution to put in the pumps.…”

“…This is because blockade of the brachial plexus at the interscalene groove with a single large-volume injection causes diaphragmatic hemiparesis in 100% of patients [10,11]. This incidence is decreased to 20% with a continuous infusion of a dilute solution [12], where 9% of patients have a subjective feeling of shortness of breath [13]. An ideal infusate in CPNBH would control postoperative pain and have minimal effects on the phrenic nerve.…”