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Continuous interscalene brachial plexus block during and after shoulder surgery.
J Haasio1, M Tuominen, P H Rosenberg
1Department of Anaesthesia, Surgical Hospital, University Central Hospital, Helsinki, Finland.
Annales Chirurgiae Et Gynaecologiae
|January 1, 1990
Summary
Continuous interscalene brachial plexus block provided effective analgesia for shoulder surgery. Plasma bupivacaine concentrations were higher in the regional anesthesia group, with manageable side effects.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Pain Management
Background:
- Continuous interscalene brachial plexus block is used for shoulder surgery analgesia.
- Optimizing local anesthetic infusion protocols is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous interscalene brachial plexus block for shoulder surgery analgesia.
- To compare plasma bupivacaine concentrations between regional and general anesthesia groups.
Main Methods:
- A continuous interscalene brachial plexus block with bupivacaine and adrenaline was administered.
- Patients received either regional anesthesia or general anesthesia with a block.
- Postoperative analgesia and plasma bupivacaine levels were monitored.
Main Results:
- Surgery was successful under regional anesthesia in 16/20 patients.
- Postoperative oxycodone use was similar between groups (1.5 +/- 0.4 vs. 1.8 +/- 0.4 doses).
- Higher plasma bupivacaine concentrations were observed in the regional anesthesia group early post-block, with no difference at 24 hours.
Conclusions:
- Continuous interscalene brachial plexus block is a viable option for shoulder surgery analgesia.
- Early higher plasma bupivacaine concentrations did not lead to significant toxicity.
- Further research may optimize infusion rates to balance efficacy and plasma concentrations.