Related Experiment Video
Updated: Feb 25, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Combined Selective Nerve Blockade and Local Infiltration Analgesia in a Total Shoulder Arthroplasty Patient With
Jason K Panchamia1, David A Olsen1, Joaquin Sanchez-Sotelo1
1From the Department of Anesthesiology and Perioperative Medicine and Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Abstract:
Interscalene brachial plexus block is considered the most complete postoperative analgesia after total shoulder arthroplasty. Interscalene brachial plexus block-induced ipsilateral hemidiaphragmatic paralysis may not be tolerated in patients with preexisting pulmonary disease. Selective distal nerve blocks avoid the risk of phrenic nerve block; however, they may provide incomplete analgesia to the glenohumeral joint. We report a case of combined selective suprascapular and axillary nerve blockade in combination with local infiltration analgesia in a patient with severe lung disease undergoing total shoulder arthroplasty. This case highlights the local infiltration analgesia technique of the shoulder joint and current diaphragm-sparing regional anesthesia blocks.
Related Concept Videos
Local Anesthetics: Clinical Application as Spinal Anesthesia
Skeletal Muscle Relaxants: Therapeutic Uses
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...

