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[Shoulder surgery using a plexus block: for or against. Against]

F Bonnet1, D Bouguet

  • 1Hôpital Henri-Mondor, Créteil.

Cahiers D'Anesthesiologie
|January 1, 1993
PubMed
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Brachial plexus block offers an alternative for shoulder surgery but requires caution. Potential issues include large anesthetic volumes, phrenic paralysis affecting breathing, and difficulty diagnosing nerve damage.

Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Orthopedic Surgery

Background:

  • Brachial plexus block is a common anesthetic technique for shoulder surgery.
  • Adequate anesthesia for shoulder procedures often requires significant local anesthetic volumes.
  • Interscalene cervical plexus block can lead to ipsilateral phrenic nerve paralysis, potentially compromising respiratory function.

Purpose of the Study:

  • To evaluate the safety and efficacy of brachial plexus block for shoulder surgery.
  • To identify potential complications associated with interscalene cervical plexus block.
  • To provide guidance on the cautious use of cervical blocks in shoulder surgery.

Main Methods:

  • Review of anesthetic techniques for shoulder surgery.
  • Analysis of complications associated with brachial plexus and cervical plexus blocks.

Related Experiment Videos

  • Discussion of diagnostic challenges in cases of nerve injury.

    • Main Results:

    • Brachial plexus block necessitates substantial local anesthetic volumes for shoulder procedures.
    • Interscalene cervical plexus block is associated with a high incidence of phrenic nerve paralysis.
    • Attributing nerve lesions to their specific cause can be challenging, especially after plexus blocks.

    Conclusions:

    • Brachial plexus block is a viable option for shoulder surgery but requires careful consideration of anesthetic volume.
    • The risk of respiratory compromise due to phrenic paralysis must be assessed in patients undergoing interscalene cervical plexus block.
    • Indications for cervical blocks in shoulder surgery should be carefully evaluated due to potential diagnostic difficulties and complications.