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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 3, May-June 2019, Pages 943-951
 

Original Article

Comparative Study on Ultrasound Guided Shoulder Block Versus Interscalene Brachial Plexus Block in Patients Undergoing Arthroscopic Shoulder Surgery

Manisha Sharma1, Ram Mohan Gurram2, Suneetha Chitithoti3, Monika Koundel4, Jahnavi Priya5

1Senior Resident in intensive care, Department of Anaesthesia, BLK Hospital, New Delhi 110005, India. 2Consultant in Anaesthesia and Pain Management, Department of Anaesthesia, Yashoda Hospital, Secunderabad, Telangana 500003, India. 3Consultant in Anaesthesia and Intensive Care, Department of Anaesthesia, Yashoda Hospital, Somajiguda, Hyderabad, Telangana 500082, India. 4Registrar in Anaesthesia and Intensive Care, Department of Anaesthesia, Care Hospital, Hitech city, Hyderabad, Telangana 5

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.36

Abstract

Background: Ultrasound (US)-guided Interscalene or Shoulder blocks are commonly used for Shoulder arthroscopic surgeries. Aim: The aim of this randomized study were to compare the block performance and onset times, effectiveness, incidence of adverse events and patient’s acceptance of US-guided Interscalene or Shoulder blocks. Methods: 68 patients were randomized to two equal groups: Shoulder block (SB) and Interscalene group (ISN). Each patient received a mixture containing 0.75% Ropivacaine. The block performance and latency times, surgical effectiveness, adverse events and patient’s acceptance were recorded. Results: The mean block performance time was 5.529 ± 1.022 mins in the ISN group and 8.559 ± 1.260 mins in the SB group. Onset of sensory block and motor block was early in ISN group. However, duration of sensory and motor block was higher in SB group. The total requirement of analgesic was higher in SB group and patients’ satisfaction was slightly more in ISN group. Also, ISN group had more complications than SB group. The haemodynamic parameters (H.R, systolic BP, diastolic BP, RR and SpO2) were recorded at 0, 4, 6, 12 & 24 hours. These parameters were all comparable in both the groups, thus statistically insignificant. Conclusion: Shoulder block can be considered in patients with Acute or Chronic respiratory distress, decreased pulmonary reserve, elderly patients, COPD patients and in patients with absolute contraindication to any degree of phrenic nerve block which almost always occurs in Interscalene nerve block.


Keywords : Brachial Plexus; Arthroscopic Shoulder surgery
Corresponding Author : Ram Mohan Gurram