Randomized, controlled trial comparing respiratory and analgesic effects of interscalene, anterior suprascapular, and posterior suprascapular nerve blocks for arthroscopic shoulder surgery
| Autor: | Zhao Kun Koo, Shivani Manohara, Vivian. W. Ho, See Seong Chang, Qian Jun Tong, Yean Chin Lim |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Vital capacity Shoulder Interscalene block Shoulder surgery medicine.medical_treatment Vital Capacity Regional anesthesia Anesthesia General lcsh:RD78.3-87.3 03 medical and health sciences FEV1/FVC ratio Arthroscopy 0302 clinical medicine 030202 anesthesiology medicine Humans Respiratory function Single-Blind Method Paresis Pain Postoperative Clinical Research Article Ropivacaine business.industry Shoulder arthroscopy Suprascapular nerve Middle Aged Brachial Plexus Block Scapula Suprascapular block Anesthesiology and Pain Medicine lcsh:Anesthesiology Anesthesia Respiratory Mechanics Female Diaphragmatic excursion medicine.symptom Analgesia business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Korean Journal of Anesthesiology Korean Journal of Anesthesiology, Vol 73, Iss 5, Pp 408-416 (2020) |
| ISSN: | 2005-7563 |
| Popis: | BackgroundInterscalene brachial plexus block (ISB) provides excellent analgesia for arthroscopic shoulder surgeries but is associated with adverse effects including hemidiaphragmatic paresis. We aimed to compare the respiratory effects, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) between suprascapular nerve block (SSB) and ISB.MethodsSixty patients were recruited and randomized into ISB, anterior SSB, and posterior SSB groups. FVC, FEV1, and diaphragmatic excursion were evaluated at baseline and 30 minutes after intervention. Blocks were performed under ultrasound guidance with 15 ml of 0.5% ropivacaine. Pain scores were assessed at 6, 12, and 24 hours postoperatively.ResultsThe ISB group showed a reduced FVC of 31.2% ± 17.5% (mean ± SD), while the anterior and posterior SSB groups had less reduction of 3.6% ± 18.6% and 6.8% ± 6.5%, respectively (P < 0.001). The ISB group showed more reduction in diaphragmatic excursion than the anterior and posterior SSB groups (median [IQR]): −85.7% (−95.3% to −63.3%) vs. −1.8% (−13.1% to 2.3%) and −1.2% (−8.8% to 16.8%), respectively (P < 0.001). The median pain scores (IQR) in the ISB and anterior SSB groups were lower than those in the posterior SSB group at 6 hours on movement: 0 (0–2), 1.8 (0–4.5) vs. 5 (2.5–8), respectively (P = 0.002). There was no significant difference in oxycodone consumption postoperatively.ConclusionsAnterior SSB preserves lung function and has a comparable analgesic effect as ISB. Thus, it is recommended for arthroscopic shoulder surgeries, especially in patients who have reduced lung function. |
| Databáze: | OpenAIRE |
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