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Related Concept Videos

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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Related Experiment Video

Updated: Mar 19, 2026

Functional and Morphological Assessment of Diaphragm Innervation by Phrenic Motor Neurons
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Continuous interscalene brachial plexus nerve block prolongs unilateral diaphragmatic dysfunction.

Philippe Cuvillon1, Frederic Le Sache2, Christophe Demattei3

  • 1Department of Anaesthesiology and Pain Management, Centre Hospitalo-Universitaire (CHU) Carémeau, Nîmes, France; Université Montpellier 1, Montpellier, France.

Anaesthesia, Critical Care & Pain Medicine
|June 23, 2016
PubMed
Summary

Continuous interscalene blocks (ISB) did not prolong pulmonary dysfunction compared to single ISB. Both methods resulted in similar diaphragm paralysis and limited pulmonary impact over 48 hours.

Keywords:
Anaesthetic techniquesAnaesthetics techniquesContinuous interscaleneEvaluationRegionalSpirometry

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Area of Science:

  • Anesthesiology
  • Pulmonary Medicine
  • Surgical Innovation

Background:

  • Single interscalene blocks (ISB) are known to impair pulmonary function within 24 hours.
  • Continuous ISBs were hypothesized to extend this pulmonary dysfunction to 48 hours.

Purpose of the Study:

  • To compare the time course of spirometric and diaphragmatic dysfunction following single versus continuous interscalene blocks.
  • To evaluate the prolonged pulmonary impact of continuous ISBs up to 48 hours post-surgery.

Main Methods:

  • Prospective study comparing single (n=30) and continuous (n=31) ISB in shoulder surgery patients.
  • Ultrasound-guided ISBs with ropivacaine; spirometry and diaphragmatic ultrasound assessed every 12 hours for 48 hours.
  • Primary endpoint: reduction in forced vital capacity (FVC) >25% from baseline.

Main Results:

  • Unilateral diaphragm paralysis observed in all patients 30 minutes post-block, with no significant difference between groups.
  • No significant difference in FVC reduction between single and continuous ISB groups over 48 hours.
  • A transient difference at 24 hours showed greater FVC and FEV1 reduction in the continuous group, but this was not sustained.

Conclusions:

  • Continuous ISB did not significantly prolong unilateral phrenic nerve paresis compared to single ISB.
  • Continuous ISB demonstrated a limited pulmonary impact, similar to single ISB, over the 48-hour study period.