Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T06:33:38.136Z Has data issue: false hasContentIssue false
  • English
  • Français

Is there a place for interscalene block performed after induction of general anaesthesia?

Published online by Cambridge University Press:  13 April 2005

A. Bogdanov  and
R. Loveland
A. Bogdanov
Affiliation:
Royal Berkshire Hospital, Reading, UK
R. Loveland
Affiliation:
Wexham Park Hospital, Slough, UK
Get access

Abstract

Summary

Background and objective: The timing of interscalene block in relation to general anaesthesia remains a controversial subject. We believe that the results of our study demonstrate that this block may be performed safely on anaesthetized patients, providing that certain conditions are met.

Methods: Five hundred and forty-eight cases of arthroscopic shoulder surgery were analysed retrospectively in order to identify the results of interscalene block performed after induction of general anaesthesia, but before the start of surgery. Patients were kept in hospital for 24 h and assessed before being discharged from the hospital and again in the period from 4 to 8 weeks after surgery. Duration of the block, quality of postoperative pain relief and neurological complications were recorded.

Results: Our study failed to reveal any permanent or long-term neurological complications attributable to interscalene block performed after induction of general anaesthesia.

Conclusion: It is our opinion that the primary factor for safe interscalene block is modification of the anaesthetic technique rather than the timing of regional block in relation to induction of general anaesthesia.

Keywords

ANAESTHESIA, CONDUCTION, nerve block, interscalene, complications, techniqueARTHROSCOPIC SURGERY, shoulderANALGESIA, postoperativeINTRAOPERATIVE COMPLICATIONS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 2 , February 2005 , pp. 107 - 110
Copyright
2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benumof JL. Permanent loss of cervical spinal cord function associated with interscalene block performed under general anesthesia. Anesthesiology 2000; 93: 1541–1544.Google Scholar
Passannante AN. Spinal anesthesia and permanent neurological deficit after interscalene block. Anesth Analg 1996; 82: 873–874.Google Scholar
Gologorsky E, Leanza RF. Contralateral anesthesia following interscalene block. Anesth Analg 1992; 75: 311–312.Google Scholar
Winnie AP. Interscalene brachial plexus block. Anesth Analg 1970; 49: 455–466.Google Scholar
Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg 1991; 72: 498–503.Google Scholar
McFarland EG, O'Neil OR, Hsu CY. Complications of shoulder arthroscopy. J South Orthop Assoc 1997; 6: 190–196.Google Scholar
Broadman ND, Cofield RH. Neurologic complications of shoulder surgery. Clin Orthop 1999; 368: 44–53.Google Scholar
Borgeat A, Ecotodramis G, Kalberer F, Benz C. Acute and non-acute complications associated with interscalene block and shoulder surgery. Anesthesiology 2001; 95: 875–880.Google Scholar
Fisher H. Regional anaesthesia – before or after general? Anaesthesia 1998; 53: 727–729.Google Scholar