What is the most commonly reported complication in the use of Interscalene regional anesthesia for shoulder surgery?
Other concerns about the routine use of interscalene blocks for shoulder surgery are due to the variable rate of successful block placement, from 84% to 98% according to case series (5, 6), and the possibility of major complications, including inadvertent spinal/epidural anaesthesia, seizure and cardiac arrest (7).
How can you avoid phrenic nerve in interscalene block?
In order to avoid phrenic nerve blocks, a reduction of the local anesthetic volume comes into consideration. Both in medical journals and in clinical practice you will find data regarding injection volumes between 20 and 50 ml [12, 13], which are higher than the 15 ml used in this study.
Which is a complication of interscalene block?
Possible complications of the interscalene nerve block include: Infection. Bleeding/Hematoma. Puncture of vascular structure.
How long does Horner’s syndrome last after interscalene block?
It appeared 40 minutes after the block with specific triad (ptosis, miosis, and exophtalmia) and quickly disappears within 2 hours and a half without any sequelae. Horner’s syndrome may be described as an unpleasant side effect because it has no clinical consequences in itself.
Does an Interscalene nerve block hurt?
There is no discomfort; the only sensation is that of the transducer moving over the skin. You will first notice a numbing sensation in the arm, shoulder, and fingers. The interscalene block will begin to take effect anywhere from 5 to 30 minutes after being administered, depending on the numbing medication used.
How do you test an interscalene block?
Ask the patient to reach the ipsilateral knee on the side to be blocked or pull the patient’s wrist toward their knee. This flattens the skin of the neck and helps to identify both the scalene muscles and the external jugular vein. Ask the patient to lift the head off the table while facing away.
What irritates the phrenic nerve?
Sometimes, an irritated phrenic nerve causes persistent hiccups that last for days or even a month or longer. Surgical procedures, tumors and other issues may irritate your phrenic nerve, bringing on persistent hiccups. Persistent hiccups can be uncomfortable and annoying.
Which nerve is spared in Interscalene block?
The interscalene block covers most of the brachial plexus, sparing the ulnar (C8-T1) nerve. It is a great block for distal clavicle, shoulder, and proximal humerus procedures.
When is an interscalene block used?
An Interscalene block is a form of regional anesthesia used in conjunction with general anesthesia for surgeries of the shoulder and upper arm. Simply stated, an Interscalene block will numb your shoulder and arm before surgery so that your brain will not receive any pain signals during and immediately after surgery.
How long does brachial plexus block last?
Nerve blocks for shoulder, arm and hand surgery can be made to last up to 24 hours. The nerve block may be part of your general anaesthetic to give you pain relief after your operation. Some operations can be done under nerve blocks alone.