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Regional Blockade of the Shoulder: Approaches and Outcomes
- Source :
- Anesthesiology Research and Practice, Anesthesiology Research and Practice, Vol 2012 (2012)
- Publication Year :
- 2012
- Publisher :
- Hindawi Publishing Corporation, 2012.
-
Abstract
- The article reviews the current literature regarding shoulder anesthesia and analgesia. Techniques and outcomes are presented that summarize our present understanding of regional anesthesia for the shoulder. Shoulder procedures producing mild to moderate pain may be managed with a single-injection interscalene block. However, studies support that moderate to severe pain, lasting for several days is best managed with a continuous interscalene block. This may cause increased extremity numbness, but will provide greater analgesia, reduce supplemental opioid consumption, improve sleep quality and patient satisfaction. In comparison to the nerve stimulation technique, ultrasound can reduce the volume of local anesthetic needed to produce an effective interscalene block. However, it has not been shown that ultrasound offers a definitive benefit in preventing major complications. The evidence indicates that the suprascapular and/or axillary nerve blocks are not as effective as an interscalene block. However in patients who are not candidates for the interscalene block, these blocks may provide a useful alternative for short-term pain relief. There is substantial evidence showing that subacromial and intra-articular injections provide little clinical benefit for postoperative analgesia. Given that these injections may be associated with irreversible chondrotoxicity, the injections are not presently recommended.
- Subjects :
- medicine.medical_specialty
business.industry
Local anesthetic
medicine.drug_class
Review Article
Critical Care and Intensive Care Medicine
Blockade
Surgery
lcsh:RD78.3-87.3
Anesthesiology and Pain Medicine
Patient satisfaction
lcsh:Anesthesiology
Regional anesthesia
Anesthesia
Regional blockade
Medicine
Major complication
Axillary nerve
business
Interscalene block
Subjects
Details
- Language :
- English
- ISSN :
- 16876970 and 16876962
- Volume :
- 2012
- Database :
- OpenAIRE
- Journal :
- Anesthesiology Research and Practice
- Accession number :
- edsair.doi.dedup.....3b3f3de7aec79bf23cef0d0ea9dfefe8