Superficial cervical plexus neuropathy after single-injection interscalene brachial plexus block
Saskia Christ1, Franziska Rindfleisch, Patrick Friederich
1Department of Anesthesiology, Critical Care Medicine and Pain Therapy, Bogenhausen Hospital, Academic Hospital of the Technical University Munich, Englschalkinger Str. 77, Munich 81925, Germany. saskia.christ@visito.de
Anesthesia and Analgesia
|November 20, 2009
Summary
Superficial cervical plexus neuropathy occurred in 7.7% of patients after interscalene brachial plexus block (ISB) for shoulder surgery. Most cases resolved within 6 months, but patients should be informed of this risk.
Area of Science:
- Anesthesiology
- Neurology
- Surgical Procedures
Background:
- Interscalene brachial plexus block (ISB) is a standard anesthesia for shoulder surgery.
- The modified lateral approach carries a risk of superficial cervical plexus injury due to neural proximity.
- Evaluating the incidence and nature of this potential complication is crucial.
Purpose of the Study:
- To determine the frequency and characteristics of superficial cervical plexus neuropathy following ISB.
- To assess the duration and resolution of symptoms associated with this complication.
Main Methods:
- A prospective study of 273 patients undergoing ISB for shoulder or proximal arm surgery.
- Clinical assessment for neuropathy symptoms pre-surgery, 24 hours post-surgery, and via telephone at 31 days and 6 months.
- Detailed examination of symptomatic patients.
Main Results:
- Superficial cervical plexus neuropathy symptoms were observed in 7.7% of patients 24 hours post-surgery.
- Symptoms included reduced sensation (hypesthesia) in cervical plexus cutaneous branches.
- 1.8% of patients experienced symptoms lasting over 31 days, with full resolution by 6 months.
Conclusions:
- Superficial cervical plexus neuropathy is an infrequent but possible complication of ISB via the modified lateral approach.
- Preprocedural patient counseling regarding this risk is recommended.
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