Hemidiaphragmatic paralysis after ultrasound-guided supraclavicular block: a prospective cohort study
| Autor: | Philippe Marty, Charlotte Martin, Jean-Mathieu Mastantuono, Vincent Minville, Pierre Laumonerie, Nicolas Bonnevialle, Anne Ferrier, Fabrice Ferré |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent Shoulder surgery medicine.medical_treatment Regional anesthesia Diaphragmatic paralysis Paralisia diafragmática Phrenic nerve lcsh:RD78.3-87.3 Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Anesthesiology 030202 anesthesiology Paralysis medicine Humans RD78.3-87.3 Ropivacaine Respiratory function Prospective Studies Anesthetics Local Prospective cohort study Ultrasonography Interventional Aged Aged 80 and over Pain Postoperative Morphine business.industry Incidence General Medicine Middle Aged Brachial Plexus Block Respiratory Paralysis Nervo frênico Anestesia regional Analgesics Opioid lcsh:Anesthesiology Anesthesia Female medicine.symptom Diaphragmatic excursion business medicine.drug |
| Zdroj: | Revista Brasileira de Anestesiologia v.69 n.6 2019 Revista Brasileira de Anestesiologia Sociedade Brasileira de Anestesiologia (SBA) instacron:SBA Brazilian Journal of Anesthesiology, Vol 69, Iss 6, Pp 580-586 (2019) |
| ISSN: | 0104-0014 |
| DOI: | 10.1016/j.bjane.2019.10.005 |
| Popis: | Background and objectives: The frequent onset of hemidiaphragmatic paralysis during interscalene block restricts its use in patients with respiratory insufficiency. Supraclavicular block could be a safe and effective alternative. Our primary objective was to assess the incidence of hemidiaphragmatic paralysis following ultrasound-guided supraclavicular block and compare it to that of interscalene block. Methods: Adults warranting elective shoulder surgery under regional anesthesia (Toulouse University Hospital) were prospectively enrolled from May 2016 to May 2017 in this observational study. Twenty millilitres of 0.375% Ropivacaine were injected preferentially targeted to the “corner pocket”. Diaphragmatic excursion was measured by ultrasonography before and 30 minutes after regional anesthesia. A reduction ≥25% in diaphragmatic excursion during a sniff test defined the hemidiaphragmatic paralysis. Dyspnoea and hypoxaemia were recorded in the recovery room. Predictive factors of hemidiaphragmatic paralysis (gender, age, weight, smoking, functional capacity) were explored. Postoperative pain was also analysed. Results: Forty-two and 43 patients from respectively the supraclavicular block and interscalene block groups were analysed. The incidence of hemidiaphragmatic paralysis was 59.5% in the supraclavicular block group compared to 95.3% in the interscalene block group (p |
| Databáze: | OpenAIRE |
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