Background And Objectives: In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine.
Methods: In the first group of patients 20mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB) were applied, while 20mL 0.25% bupivacaine was given via intra-articular (IA) administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA) with morphine was used in all three groups for postoperative analgesia.
Results: In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6h and the same was true for total morphine consumption in 24h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2h and lower than the control group in the 4(th) and 6(th) hours (p<0.05). In the IA group, VASr and VASm scores in the 2(nd), 4(th) and 6(th) hours were lower than in the control group (p<0.05).
Conclusion: Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.bjan.2014.06.007 | DOI Listing |
Diagnostics (Basel)
December 2024
PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain.
Background: When performing the Upper Limb Neurodynamic Test 1 (ULNT1), the order of joint movement can be varied to place more stress onto certain nerve segments. However, the mechanisms underlying this phenomenon are still unclear. This study aimed to analyze the differences in the stiffness of the median nerve (MN) and the brachial plexus (BP) using ultrasound shear wave elastography during three sequences of the ULNT1: standard (ULNT1-STD), distal-to-proximal (ULNT1-DIST), and proximal-to-distal (ULNT1-PROX).
View Article and Find Full Text PDFReg Anesth Pain Med
December 2024
Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.
Introduction: Regional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia.
View Article and Find Full Text PDFCurr Pain Headache Rep
December 2024
Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Purpose Of Review: Peripheral nerve blocks are performed using local anesthetics that are commonly performed prior to surgery to either be the sole anesthetic and/or for postoperative pain management. Interscalene blocks are a specific type of nerve block that targets the superior and middle trunks of the brachial plexus inhibiting transmission of pain signals from the upper extremities to the central nervous system making them useful in mitigating pain following surgeries involving the shoulder, upper arm, and elbow.
Recent Findings: Previously, interscalene blocks were performed with a nerve stimulator, which is an instrument designed to generate a twitch in surrounding muscles to verify the anesthetic block was placed in the correct location.
BMC Anesthesiol
December 2024
Department of Anesthesiology, Ningbo No.2 Hospital, No.41, Northwest Street, Ningbo, 315010, P.R. China.
Background: Developing proficiency in ultrasound-guided nerve block (UGNB) demands an intricate understanding of cross-sectional anatomy as well as spatial reasoning, which is a big challenge for beginners. The aim of this pilot study was to evaluate the feasibility of virtual reality (VR)-facilitated anatomy education in the first performance of ultrasound-guided interscalene brachial plexus blockade among novice anesthesiologists. We carried out pilot testing of this hypothesis using a prospective, single blind, randomized controlled trial.
View Article and Find Full Text PDFClin J Pain
February 2025
Department of Anesthesiology and Pain Clinic, Xuzhou Central Hospital, Xuzhou, Jiangsu Province, China.
Objectives: This prospective, randomized, double-blind trial was performed to investigate the effect on rebound pain incidence of mixing dexmedetomidine (DEX) with local anesthetics in a combined injection interscalene block (ISB) during shoulder arthroscopy.
Methods: Forty-seven patients were enrolled in this study. Patients were randomly assigned to 2 groups: Group DEX and Group Control received ultrasound-guided ISB using 12 mL of 0.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!