Journal of Shoulder and Elbow Surgery
Volume 20, Issue 2 , Pages 308-314, March 2011

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

  • Gary Misamore, MD

      Affiliations

    • Methodist Sports Medicine / The Orthopedic Specialists, Indianapolis, IN, USA
    • Corresponding Author InformationReprint requests: Gary Misamore, MD, Methodist Sports Medicine / The Orthopedic Specialists, 201 Pennsylvania Pkwy, Ste 325, Indianapolis, IN 46280.
    • ,
  • Brian Webb, MD

      Affiliations

    • Methodist Sports Medicine / The Orthopedic Specialists, Indianapolis, IN, USA
    • ,
  • Sherman McMurray, MD

      Affiliations

    • Anesthesia Consultants of Indianapolis, Indianapolis, IN, USA
    • ,
  • Peter Sallay, MD

      Affiliations

    • Methodist Sports Medicine / The Orthopedic Specialists, Indianapolis, IN, USA

published online 16 August 2010.

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.

Level of evidence: Level IV, Case Series, Treatment Study

Keywords: Shoulder, interscalene, block, brachial plexus, general anesthesia

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 The study, #03-089, was approved by review board of the Methodist Hospital, Indianapolis, and all subjects gave written, informed consent.

PII: S1058-2746(10)00189-8

doi:10.1016/j.jse.2010.04.043

Journal of Shoulder and Elbow Surgery
Volume 20, Issue 2 , Pages 308-314, March 2011

Article Tools