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Respiratory impact of local anaesthetic volume after an interscalene brachial plexus block with an extrafascial injection: a randomised controlled double-blinded trial.
Br J Anaesth
January 2025
Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland. Electronic address:
Background: We have previously demonstrated that an extrafascial injection of 20 ml of local anaesthetic for interscalene brachial plexus block (ISB) reduces the rate of hemidiaphragmatic paralysis by 70% compared with an intrafascial injection, with similar efficacy. In this double-blind trial, we tested the hypothesis that a local anaesthetic volume of 10 ml injected extrafascially would reduce the rate of hemidiaphragmatic paralysis vs a volume of 20 ml, while providing similar analgesia.
Methods: Sixty ASA physical status 1-3 patients scheduled for elective shoulder surgery under general anaesthesia were randomised to receive ultrasound-guided extrafascial ISB using ropivacaine 0.
Subcutaneous Pectoral Edema After Arthroscopic Labral Repair Despite Normal Irrigation Fluid Usage and Surgery Duration.
Orthop Surg
January 2025
Department of Orthopaedics and Traumatology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Objectives: Edema after shoulder arthroscopic surgery poses concerns due to its potential complications such as compartment syndrome, nerve damage, and respiratory issues. This study aimed to investigate the acute accumulation of subcutaneous fluid after shoulder arthroscopy.
Methods: A prospective cohort study, providing Level III evidence was conducted on 50 patients undergoing arthroscopic shoulder surgery under interscalene block anaesthesia from September to December 2023.
Continuous Catheter Versus Single-Shot Interscalene Block in Shoulder Surgery: A Review and Recommendations for Postoperative Pain Management.
Cureus
December 2024
Emergency Medicine, Henry Ford Health System, Detroit, USA.
Shoulder arthroscopic and arthroplastic surgeries are associated with significant postoperative pain, which can delay recovery and increase opioid consumption. Interscalene blocks (ISBs) are a commonly used method to manage this pain, either as single-shot injections or continuous catheter infusions (CISBs). This review synthesizes findings from studies conducted in the past five years, comparing the efficacy, complications, and outcomes of single-shot ISBs versus CISBs for postoperative pain management in shoulder surgeries.
View Article and Find Full Text PDFAdmixture of Liposomal Bupivacaine and Bupivacaine Hydrochloride for Peripheral Nerve Blocks in Adolescents Undergoing Orthopedic Surgery: An Observational Cohort Study.
J Clin Med
December 2024
Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC 27710, USA.
: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems.
View Article and Find Full Text PDFThe Use of Liposomal Bupivacaine for Pain Control After Shoulder Surgery: A Systematic Review and Meta-analysis.
Am J Sports Med
January 2025
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.
Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.
Study Design: Systematic review and meta-analysis; Level of evidence, 1.
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