scholarly journals Extrafascial injection for interscalene brachial plexus block reduces respiratory complications compared with a conventional intrafascial injection: a randomized, controlled, double-blind trial † †This report was previously presented in part at the annual meeting of the European Society of Regional Anaesthesia and Pain Medicine, Ljubljana, Slovenia, September 2–5, 2015.

2016 ◽  
Vol 116 (4) ◽  
pp. 531-537 ◽  
Author(s):  
N Palhais ◽  
R Brull ◽  
C Kern ◽  
A Jacot-Guillarmod ◽  
A Charmoy ◽  
...  
Keyword(s):  
European Society ◽  
Regional Anaesthesia ◽  
Brachial Plexus Block ◽  
Double Blind Trial ◽  
Pain Medicine ◽  
Respiratory Complications ◽  
Double Blind ◽  
Interscalene Brachial Plexus Block ◽  
Randomized Controlled ◽  
Plexus Block

scholarly journals Diaphragmatic paralysis, respiratory function, and postoperative pain after interscalene brachial plexus block with a reduced dose of 10 ml levobupivacaine 0.25% versus a 20 ml dose in patients undergoing arthroscopic shoulder surgery: study protocol for the randomized controlled double-blind REDOLEV study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
P. Oliver-Fornies ◽  
J. P. Ortega Lahuerta ◽  
R. Gomez Gomez ◽  
I. Gonzalo Pellicer ◽  
L. Oliden Gutierrez ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Shoulder Surgery ◽  
Double Blind ◽  
Interscalene Brachial Plexus Block ◽  
Randomized Controlled ◽  
Arthroscopic Shoulder Surgery ◽  
Low Volume ◽  
Plexus Block

Abstract Background Arthroscopic shoulder surgery causes severe postoperative pain. An interscalene brachial plexus block provides adequate analgesia, but unintended spread of the local anesthetic administered may result in a phrenic nerve block, usually associated with a nonnegligible incidence of acute hemidiaphragmatic paralysis. The main purpose of this trial will be to analyze the incidence of hemidiaphragmatic paralysis ensuing after interscalene brachial plexus block in patients undergoing arthroscopic shoulder surgery administered a standard volume (20 ml) vs. a low volume (10 ml) of levobupivacaine 0.25%. Methods This will be a prospective double-blind randomized controlled single-center two-arm comparative trial. Forty-eight patients will be included. The primary goal will be to ultrasonographically determine the incidence of hemidiaphragmatic paralysis by calculating the diaphragmatic thickness ratio in each group. The secondary goals will be to compare the two arms in terms of (1) decrease in forced vital capacity and (2) in forced expiratory volume at 1 s by spirometry; (3) decrease in diaphragmatic excursion by ultrasound; (4) 24-h total intravenous morphine consumption; (5) time to first opioid request of a patient-controlled analgesia pump; and (6) postoperative complications. Discussion This trial will demonstrate that a low-volume interscalene brachial plexus block decreases hemidiaphragmatic paralysis following arthroscopic shoulder surgery according to spirometry and ultrasound measurements and does not provide inferior postoperative analgesia to the standard volume, as measured by opioid requirements. Trial registration EudraCT and Spanish Trial Register (REec) registration number: 2019-003855-12 (registered on 7 January 2020). ClinicalTrials.gov identification number: NCT04385966 (retrospectively registered on 8 May 2020). Ethics Committee approval: EC19/093 (18 December 2019).

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