Ultrasound-guided interscalene block versus intravenous analgesia and sedation for reduction of first anterior shoulder dislocation

Yao, Liwei; Dong, Weixin; Wu, Zeting; Zhao, Qingzhen; Mao, Haijiao

doi:10.1016/j.ajem.2022.03.047

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…The interscalene brachial plexus block provides good coverage to the shoulder region and is commonly used in adult EDs, 13 mostly for shoulder dislocations. In children, shoulder dislocations are far less common than more distal upper extremity injuries.…”

Section: Discussionmentioning

confidence: 99%

Building Blocks—A Block-by-Block Approach to Better Emergency Care in Children

Katzir,

Ganor,

Berant

et al. 2024

Pediatr Emer Care

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Regional anesthesia has gained prevalence over recent years in the emergency department setting, mainly in adults. Various frameworks have been suggested as toolkits encompassing the common procedures found in the adult setting. To date, no such framework exists for the pediatric emergency setting. Objective We describe a case series of regional nerve blocks, which comprise an adapted framework for the pediatric emergency setting and were performed by pediatric emergency medicine physicians. Methods A case series of 8 different ultrasound-guided nerve blocks and 1 anatomical block, performed in 11 pediatric patients, aged 7 weeks to 17 years. Results All blocks resulted in adequate analgesia. No procedural complications were observed. Conclusion We describe a set of nerve blocks performed by emergency medicine physicians in the pediatric population in an ED setting. In suitable settings, this is a safe and effective tool for procedural analgesia or for pain management. In such cases, performing an ultrasound-guided nerve block in the ED is a viable alternative for repeated doses of opiates, deep procedural sedation, or the operating theater. We propose this set of regional anesthesia procedures as a pediatric-adapted toolkit for the emergency physician to be performed in children in the ED setting. Adopting this set of procedures ensures better and safer care for children and provides a training framework for pediatric ED physicians.

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Section: Discussionmentioning

confidence: 99%

Building Blocks—A Block-by-Block Approach to Better Emergency Care in Children

Katzir,

Ganor,

Berant

et al. 2024

Pediatr Emer Care

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show abstract

“…There are mixed results from various studies that compare interscalene block versus intravenous sedation for the reduction of shoulder dislocations. In a recent publication, the anesthesia time and reduction time was shorter for the intravenous sedation group although the time to hospital discharge was reduced for the interscalene group, with a higher satisfaction level, while pain scores were similar between groups [8].…”

Section: Upper Limb Blocksmentioning

confidence: 91%

Regional anesthesia in the emergency department outside the operating theatre

Wolmarans

Albrecht

2023

Current Opinion in Anaesthesiology

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Purpose of review Moderate to severe pain is common and remains a significant problem in the emergency department and regional anesthesia provides optimal and safe pain relief. This review aims to discuss the benefits, indications of the most common ultrasound-guided regional anesthesia techniques that can be provided by clinicians in the emergency department as part of multimodal analgesia. We will also comment on the education and training for effective and safe ultrasound-guided regional anesthesia in the emergency department. Recent findings The emergence of multiple new fascial plane blocks that provide easier to learn alternatives, yet effective analgesia for specific patient groups can now safely be taught and utilized in the emergency department. Summary Emergency physicians are perfectly placed to utilize the advantages of ultrasound-guided regional anesthesia. Various techniques can now be employed to cover most of the painful injuries presenting to the emergency department, thus modifying the morbidity and outcomes of emergency patients. Some of the new techniques require minimal training, provide safe and effective pain relief with low risk of complications. Ultrasound-guided regional anesthetic techniques should form an integral part of the curriculum of emergency department physicians.

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“…A study by Yao et al found that the time to discharge was shorter in a group receiving an interscalene block versus PSA for shoulder reduction. 50 Another study that looked at interscalene block versus sedation versus general anesthesia for shoulder reduction showed similar clinical outcomes between the 3 groups, but the joint repositioning procedure time was the shortest, and the patient satisfaction scores were the highest in the interscalene group. 51 Similar results have been shown in other upper extremity fractures and dislocations.…”

Section: Peripheral Regional Anesthesiamentioning

confidence: 97%

“…An interscalene block involves targeting the brachial plexus at the level of the roots, typically targeting the C5 and C6 nerve roots with 10 to 15 mL of local anesthetic. A study by Yao et al found that the time to discharge was shorter in a group receiving an interscalene block versus PSA for shoulder reduction 50 . Another study that looked at interscalene block versus sedation versus general anesthesia for shoulder reduction showed similar clinical outcomes between the 3 groups, but the joint repositioning procedure time was the shortest, and the patient satisfaction scores were the highest in the interscalene group 51 …”

Section: Upper Extremity Trauma Analgesiamentioning

confidence: 99%

Unique considerations in regional anesthesia for emergency department and non-or procedures

Scholzen,

Silva,

Schroeder

2023

International Anesthesiology Clinics

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Ultrasound-guided interscalene block versus intravenous analgesia and sedation for reduction of first anterior shoulder dislocation

Cited by 7 publications

References 18 publications

Building Blocks—A Block-by-Block Approach to Better Emergency Care in Children

Building Blocks—A Block-by-Block Approach to Better Emergency Care in Children

Regional anesthesia in the emergency department outside the operating theatre

Unique considerations in regional anesthesia for emergency department and non-or procedures

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