A randomised controlled trial of shoulder block vs. interscalene brachial plexus block for ventilatory function after shoulder arthroscopy.

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Serval ID
serval:BIB_F5144B30AD87
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A randomised controlled trial of shoulder block vs. interscalene brachial plexus block for ventilatory function after shoulder arthroscopy.
Journal
Anaesthesia
Author(s)
Rhyner P., Kirkham K., Hirotsu C., Farron A., Albrecht E.
ISSN
1365-2044 (Electronic)
ISSN-L
0003-2409
Publication state
Published
Issued date
04/2020
Peer-reviewed
Oui
Volume
75
Number
4
Pages
493-498
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The shoulder block may impair ventilatory function and diaphragmatic movement less than the interscalene brachial plexus block. We randomly allocated 30 adults who underwent shoulder arthroscopy under general anaesthesia to ultrasound-guided shoulder block or interscalene block with 20 ml bupivacaine 0.5%. The primary outcome, rate of ultrasound-measured hemidiaphragmatic excursion < 25% of baseline 30 min after blockade, was reduced from 12/15 with brachial plexus block to 2/15 with shoulder block, a difference (95%CI) of 67% (40-93%), p < 0.001. The mean (SD) numeric rating scale pain scores at rest after shoulder block were higher than after interscalene block at two postoperative hours, 1.4 (1.2) vs. 0.3 (0.7), p = 0.02, but lower at 24 postoperative hours, 1.3 (1.3) vs. 3.4 (2.3), p = 0.008. Mean (SD) pain scores on movement in the shoulder and interscalene blocks were similar, with respective values of 1.9 (1.9) vs. 0.7 (1.2), p = 0.13 at two postoperative hours and 3.7 (2.3) vs. 5.3 (2.5), p = 0.41, at 24 postoperative hours.
Keywords
Adult, Anesthetics, Local/therapeutic use, Arthroscopy/methods, Brachial Plexus Block/methods, Bupivacaine/therapeutic use, Female, Humans, Male, Nerve Block/methods, Respiratory Insufficiency/prevention & control, Shoulder/innervation, Shoulder/surgery, Ultrasonography, Interventional, analgesia, peripheral nerve block, postoperative pain, shoulder arthroscopy
Pubmed
Web of science
Create date
03/01/2020 16:39
Last modification date
03/04/2020 5:19
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