A prospective analysis of interscalene brachial plexus blocks performed under general anesthesia

Background The purpose of this prospective study was to assess the safety and efficacy of interscalene brachial plexus block anesthesia when performed on patients who were anesthetized with a general anesthetic prior to the performance of the block. Methods Patients were assessed postoperatively thr...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2011-03, Vol.20 (2), p.308-314
Main Authors: Misamore, Gary, MD, Webb, Brian, MD, McMurray, Sherman, MD, Sallay, Peter, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia
Anesthesia, General
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
block
brachial plexus
Brachial Plexus - drug effects
Diseases of the osteoarticular system
Female
general anesthesia
General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation
Humans
interscalene
Male
Medical sciences
Middle Aged
Nerve Block
Orthopedic Procedures
Orthopedics
Prospective Studies
Shoulder
Shoulder - surgery
Treatment Outcome
Young Adult
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Summary:Background The purpose of this prospective study was to assess the safety and efficacy of interscalene brachial plexus block anesthesia when performed on patients who were anesthetized with a general anesthetic prior to the performance of the block. Methods Patients were assessed postoperatively through surveys, interviews, and physical examinations to document block success, duration of anesthesia, block side effects, and persistent neurological complications. Nine-hundred fifty-one patients were available for the analysis. Results The overall block success rate was 97% and the mean duration of anesthesia provided by the blocks was 23.9 hours. Immediate postoperative block side effects occurred in 16% (142 of 910), persistent neurological complications occurred in 4.4% (40 of 910) of patients, and long-term neurologic complications occurred in 0.8% (8 of 910). Conclusion Our study results suggest that the rates of success and complications associated with the performance of interscalene block regional anesthesia performed after induction of general anesthesia are similar to the results demonstrated in prior studies in which brachial plexus block was performed on nonanesthetized patients. Although significant complications were not common, this procedure is not without risk and can result in long-term neurologic complications.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2010.04.043