Effective analgesia with ultrasound-guided interscalene brachial plexus block for postoperative pain control after arthroscopic rotator cuff repair

Shin, Sang‐Wook; Byeon, Gyeong-Jo; Yoon, Ji-Uk; Ok, Young-Min; Baek, Sun‐Yong; Kim, Kyung-Hoon; Lee, Seung-Jun

doi:10.1007/s00540-013-1681-x

Cited by 28 publications

(28 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interscalene brachial plexus block is an effective technique to provide intraoperative analgesia and postsurgical pain relief after shoulder surgery [11][12][13] . Though the US-guided interscalene brachial plexus is quite popular for the management of upper extremity injuries by emergency physicians 14 , the traditional technique of US-guided interscalene approach does not provide effective anaesthesia of the distal extremity and may affect the phrenic nerve, leading to temporary paralysis of the ipsilateral hemidiaphragm 15 .…”

mentioning

confidence: 99%

Comparison of Ultrasound-Guided Supraclavicular, Infraclavicular and Below-C6 Interscalene Brachial Plexus Block for Upper Limb Surgery: A Randomised, Observer-Blinded Study

Bharti

Bhardawaj

2015

Anaesth Intensive Care

View full text Add to dashboard Cite

This prospective, randomised, observer-blinded study was conducted to compare the ease of performance and surgical effectiveness of interscalene block below the C6 nerve root with supraclavicular and infraclavicular techniques of brachial plexus block for upper arm and forearm surgery. Sixty adult patients of American Society of Anesthesiologists grade 1 to 3, undergoing upper limb surgery, were randomly allocated into three groups. Group SC received supraclavicular blockade, group IC received infraclavicular blockade and Group IS received interscalene blockade. All blocks were guided by ultrasound with nerve stimulator confirmation. The anaesthetic mixture consisted of 0.5 ml/kg of equal volumes of 0.75% ropivacaine and 2% lignocaine-adrenaline. The imaging and block performance time, onset time, success rate, duration of block, and duration of postoperative analgesia were recorded by a blinded observer. The onset time was significantly longer in the interscalene group as compared with supraclavicular and infraclavicular approaches. The imaging time and block performance time were comparable between groups. No significant differences were observed between the three groups in terms of block-related pain scores, success rates, duration of block or of postoperative analgesia. Two patients in the interscalene group developed clinically detectable phrenic nerve palsy. Our findings indicate that, although interscalene block below the C6 nerve root can provide surgical anaesthesia for forearm and hand surgery, it appears to have a longer onset time than supra-and infraclavicular approaches and an unacceptable incidence of phrenic nerve palsy.

show abstract

mentioning

confidence: 99%

Comparison of Ultrasound-Guided Supraclavicular, Infraclavicular and Below-C6 Interscalene Brachial Plexus Block for Upper Limb Surgery: A Randomised, Observer-Blinded Study

Bharti

Bhardawaj

2015

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

“…Staff-administered pain questionnaires were applied in 27 out of 47 included studies [11–14,16–21,23–39]. Nine studies [ 10 , 18 , 39 – 45 ] used a patient-administered pain questionnaire, and 12 studies [ 15 , 46 – 56 ] did not specify their method. One study used a staff-assessed method in the hospital and a self-assessed method after patient discharge [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

“…Some studies used more than one method due to variations in analgesic protocols, such as different scheduled analgesics and rescue analgesics. In most cases, only the rescue analgesics were recorded (in mg or number of doses) [ 14 , 21 , 24 , 47 , 49 ], or the number of patients requesting [ 34 , 54 , 56 ] (or not requesting) analgesics [ 19 ]. For patients using patient-controlled analgesia (PCA, usually with intravenous opioid), the number of attempts, number of doses, and/or cumulated dose (for example during 24 hours) were reported [ 31 , 37 , 41 , 48 , 50 , 52 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

Acute postoperative pain after arthroscopic rotator cuff surgery: A review of methods of pain assessment

Rasmussen

Nikolajsen

Bjørnholdt

2018

SICOT-J

View full text Add to dashboard Cite

Introduction: Pain can be severe during the first days after arthroscopic surgery, and acute pain is an important outcome in clinical trials of surgical technique or anaesthetic strategy. A standardized, validated method of assessing acute postoperative pain would improve the quality of clinical studies, and facilitate systematic reviews and meta-analyses. A step on the way towards this standard is to investigate the methods most commonly used in recent literature.Methods: PubMed and CINAHL databases were searched, including studies of arthroscopic rotator cuff surgery with a primary pain-related outcome during the first postoperative week, published in English from 2012 to 2017.Results: A total of 47 studies were included, all measuring pain intensity using a pain rating scale. Most frequently used was the visual analogue scale using the anchors “no pain” and “worst pain imaginable”, with recordings at 1, 2, 4, 6, 8, 12, and 24 hours postoperatively. A total of 34 studies recorded analgesic consumption, usually as average cumulated consumption in mg. Time to first analgesic request or first pain were recorded in 11 studies, and 4 different starting points were used.Discussion: This review describes the currently most common methods of assessing acute postoperative pain in clinical trials of arthroscopic shoulder surgery involving rotator cuff repair, and the large variety of methods applied. Based on this study and international guidelines, several recommendations on how to measure and report postoperative pain outcomes in future trials are proposed.

show abstract

“…4) Various options are available to control postoperative pain following shoulder surgery, including intravenous patient-controlled analgesia (IV-PCA), subacromial or intraarticular injection, suprascapular nerve block (SSB), interscalene block (ISB), and continuous brachial plexus blockade. 5) Although ISB is associated with several potential side effects, such as nerve block failure, phrenic nerve palsy, and rebound pain, it has been proven to be one of the most effective analgesic treatment modalities for arthroscopic shoulder surgery. Single ISB has a high success rate and lesser complications as compared with other modalities, especially when administered with ultrasound (US) guidance.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Additional Intravenous Patient-controlled Analgesia to the Interscalene Block in Arthroscopic Shoulder Surgery: A Prospective Randomized Controlled Study

Shin

Seo²,

Kim

et al. 2017

Clinics in Shoulder and Elbow

View full text Add to dashboard Cite

Background: The purpose is to determine the efficacy of additional intravenous patient-controlled analgesia (IV-PCA) by comparing the analgesic effects between interscalene block (ISB) combined with IV-PCA and single ISB after arthroscopic shoulder surgery. Methods: A total of 213 patients who underwent arthroscopic shoulder surgery were divided into two groups based on the type of perioperative anesthesia. The single ISB group included 100 patients, while the IV-PCA group included 113 patients. The visual analogue scale for pain (VAS pain) scores were assessed at 12, 24, and 48 hours postoperatively in accordance with shoulder pathology. Postoperative narcotics-related complications and consumption of additional non-steroidal anti-inflammatory drugs between the two groups were compared. Results: VAS pain showed no significant difference between the two groups at most points of the postoperative timeline, regardless of shoulder pathology, except in patients with rotator cuff repair at postoperative 24 hours. Although the IV-PCA group showed a statistically lower VAS pain score than the ISB group at postoperative 24 hours (p=0.04), the difference in the VAS pain score was only 9.0 mm in patients with rotator cuff repair. Narcotics-related complications were observed more frequently in the IV-PCA group than in the ISB group for patients with rotator cuff repair. Conclusions: Additional IV-PCA demonstrated no booster effect for immediate pain control in patients undergoing arthroscopic shoulder surgery with preoperative single ISB. Furthermore, patients with IV-PCA experienced greater narcotics-related complications. (Clin Shoulder Elbow 2017;20(1):10-17)

show abstract

Effective analgesia with ultrasound-guided interscalene brachial plexus block for postoperative pain control after arthroscopic rotator cuff repair

Abstract: The bolus dose of 0.2 % ropivacaine using US-guided CBPB would provide equivalent analgesic efficacy comparable with the basal infusion and motor weakness comparable with IV-PCA after arthroscopic rotator cuff repair.

Cited by 28 publications

References 13 publications

Comparison of Ultrasound-Guided Supraclavicular, Infraclavicular and Below-C6 Interscalene Brachial Plexus Block for Upper Limb Surgery: A Randomised, Observer-Blinded Study

Comparison of Ultrasound-Guided Supraclavicular, Infraclavicular and Below-C6 Interscalene Brachial Plexus Block for Upper Limb Surgery: A Randomised, Observer-Blinded Study

Acute postoperative pain after arthroscopic rotator cuff surgery: A review of methods of pain assessment

The Efficacy of Additional Intravenous Patient-controlled Analgesia to the Interscalene Block in Arthroscopic Shoulder Surgery: A Prospective Randomized Controlled Study

Contact Info

Product

Resources

About