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Interscalene brachial plexus block anesthesia for upper extremity surgery.

P Kuflik, A Ankolekar, S A Stuchin

    The Journal of Hand Surgery
    |March 1, 1986
    PubMed
    Summary
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    The interscalene brachial plexus block provides effective upper extremity anesthesia in 93% of cases, particularly useful for rheumatoid patients. This technique avoids complications seen with other regional anesthesia methods.

    Area of Science:

    • Anesthesiology
    • Orthopedic Surgery
    • Rheumatology

    Background:

    • Rheumatoid arthritis patients often require upper extremity surgery.
    • Regional anesthesia is preferred to minimize systemic effects.
    • The interscalene brachial plexus block is a common technique for upper extremity anesthesia.

    Purpose of the Study:

    • To evaluate the efficacy and safety of the interscalene brachial plexus block for upper extremity anesthesia.
    • To assess the success rate in a patient population with a high prevalence of rheumatoid arthritis.
    • To compare outcomes with other regional anesthesia techniques.

    Main Methods:

    • Review of 88 cases utilizing the interscalene brachial plexus block.
    • Application of Winnie's interscalene approach.

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  • Analysis of anesthesia effectiveness across different surgical sites in the upper extremity.
  • Main Results:

    • Successful anesthesia achieved in 93% of cases.
    • Higher failure rates noted for distal upper extremity procedures.
    • Effective anesthesia for the shoulder and entire upper extremity was demonstrated.
    • Avoidance of tourniquet pain, pneumothorax, and anesthetic toxicity.

    Conclusions:

    • The interscalene brachial plexus block is a reliable and effective method for upper extremity anesthesia, even in patients with rheumatoid arthritis.
    • The technique successfully obviates limitations associated with other regional anesthesia approaches.
    • It offers a safe alternative for shoulder and upper limb surgeries.