Pulmonary Function Changes During Interscalene Brachial Plexus Block

Urmey, William F.; Gloeggler, Paul J.

doi:10.1097/00132586-199406000-00029

Cited by 38 publications

(55 citation statements)

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“…Umery & Mcdonald (1992), observed, after interscalene block with 45 mL of 1.5% mepivacaine (in 8 patients), a reduction in FVC of 27 ± 4.3% 5 . In another study, Urmey & Gloeggler (1993) observed a reduction of 40.9% ± 11.7% in patients who received 45 mL of 1.5% mepivacaine (10 patients), and 32 ± 8.9% in patients who received 20 mL of the same drug (10 patients) 14 . Dagli et al (1998), using 20 mL of 1% lidocaine and 20 mL of 0.5% bupivacaine in posterior interscalene block, observed a mean reduction of 36.8% in FVC (29 patients) 15 .…”

Section: Discussionmentioning

confidence: 92%

Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar

Hortense

Perez

Amaral

et al. 2010

Rev. Bras. Anestesiol.

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Section: Discussionmentioning

confidence: 92%

Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar

Hortense

Perez

Amaral

et al. 2010

Rev. Bras. Anestesiol.

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“…However, close proximity to viable structures in the neck and thorax convey a potential risk for complications. Blockade of the recurrent laryngeal and phrenic nerves leading to stridor and hemidiaphragmatic paralysis, respectively, can necessitate mechanical ventilation and prove to be troublesome, especially in patients suffering from preexisting pulmonary morbidity [33]. Incidence of hemidiaphragmatic paralysis, along with reduction of the functional vital capacity, was reported to occur in almost all patients receiving an interscalene plexus block [10,34].…”

Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Blocks in Shoulder Arthroplasty: How Do They Influence Complications and Length of Stay?

Stundner

Rasul

Chiu

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Regional anesthesia has proven to be a highly effective technique for pain control after total shoulder arthroplasty. However, concerns have been raised about the safety of upper-extremity nerve blocks, particularly with respect to the incidence of perioperative respiratory and neurologic complications, and little is known about their influence, if any, on length of stay after surgery. Questions/purposes Using a large national cohort, we asked: (1) How frequently are upper-extremity peripheral nerve blocks added to general anesthesia in patients undergoing total shoulder arthroplasty? (2) Are there differences in the incidence of and adjusted risk for major perioperative complications and mortality between patients receiving general anesthesia with and without nerve blocks? And (3) does resource utilization (blood product transfusion, intensive care unit admission, length of stay) differ between groups? Methods We searched a nationwide discharge database for patients undergoing total shoulder arthroplasty under general anesthesia with or without addition of a nerve Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. The institution of one of the authors (SGM) has received, during the study, funding from the Anna-Maria and Stephen Kellen Physician-Scientist Career Development Award provided by the Hospital for Special Surgery. One or more of the authors (RR, YLC, XS, MM) has received, during the study,

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“…However, patients whose ability to ventilate is dependent on bilateral diaphragmatic function may not tolerate interscalene block anesthesia since the incidence of ipsilateral hemidiaphragmatic paralysis has been reported to be 100% following interscalene block [9][10][11].…”

Section: Regional Block Anesthesiamentioning

confidence: 99%

“…In patients with small airway disease or parenchymal distension, active inspiration and expiration may be essential for respiratory exchange, and the loss of contribution of the ipsilateral hemidiaphragm to inspiration is not as benign [11]. Elevation of the hemidiaphragm also decreases the FRC and alters the mechanical function of the chest wall, further decreasing respiratory function [11].…”

Section: Complications Of Interscalene Brachial Plexus Blockmentioning

confidence: 99%

“…Elevation of the hemidiaphragm also decreases the FRC and alters the mechanical function of the chest wall, further decreasing respiratory function [11]. Hence it is possible that blockade of hemidiaphragmatic function may render the geriatric patient clinically unstable due to a diminution of pulmonary reserves.…”

Section: Complications Of Interscalene Brachial Plexus Blockmentioning

confidence: 99%

See 1 more Smart Citation

Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia

Ghaleb¹,

Dilley²

2012

TOATJ

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A review of the literature regarding anesthesia for shoulder surgery was performed. Current anesthetic techniques available include regional, general, or a combination of regional and general. We discuss each of these techniques, with an emphasis on regional (specifically interscalene block), in detail. Current evidence supports both regional and general anesthesia to be safe and efficient techniques. The interscalene block is considered by most to provide the best surgical anesthesia and is the most commonly performed block for shoulder surgery. This paper aims to review the performance of the interscalene block and to discuss alternative choices for shoulder surgery, namely general anesthesia and a combined general/regional technique. We also aim to provide considerations to aid in the performance of a safely administered anesthetic.

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Pulmonary Function Changes During Interscalene Brachial Plexus Block

Cited by 38 publications

References 0 publications

Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar

Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar

Peripheral Nerve Blocks in Shoulder Arthroplasty: How Do They Influence Complications and Length of Stay?

Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia

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