ultrasound-guided out-of-plane vs. in-plane interscalene catheters: a randomized, prospective study
Authors
abstract
objectives to compare an out-of-plane interscalene catheter technique to the in-plane technique in a randomized clinical trial. patients and methods eighty-four patients undergoing open shoulder surgery were randomized to either the in-plane or out-of-plane ultrasound-guided continuous interscalene technique. the primary outcome was vas pain rating at 24 hours. secondary outcomes included pain ratings in the recovery room and at 48 hours, morphine consumption, the incidence of catheter dislodgments, procedure time, and block difficulty. procedural data and all pain ratings were collected by blinded observers. conclusions our out-of-plane technique did not provide superior analgesia to the in-plane technique. it did not increase the number of complications. our technique is an acceptable alternative in situations where the in-plane technique is difficult to perform. results there were no differences in the primary outcome of median vas pain rating at 24 hours between the out-of-plane and in-plane groups (1.50; iqr, [0 - 4.38] vs. 1.25; iqr, [0 - 3.75]; p = 0.57). there were also no differences, respectively, between out-of-plane and in-plane median pacu pain ratings (1.0; iqr, [0 - 3.5] vs. 0.25; iqr, [0 - 2.5]; p = 0.08) and median 48-hour pain ratings (1.25; iqr, [1.25 - 2.63] vs. 0.50; iqr, [0 - 1.88]; p = 0.30). there were no differences in any other secondary endpoint. background continuous interscalene blocks provide excellent analgesia after shoulder surgery. although the safety of the ultrasound-guided in-plane approach has been touted, technical and patient factors can limit this approach. we developed a caudad-to-cephalad out-of-plane approach and hypothesized that it would decrease pain ratings due to better catheter alignment with the brachial plexus compared to the in-plane technique in a randomized, controlled study.
similar resources
Ultrasound-Guided Out-of-Plane vs. In-Plane Interscalene Catheters: A Randomized, Prospective Study.
BACKGROUND Continuous interscalene blocks provide excellent analgesia after shoulder surgery. Although the safety of the ultrasound-guided in-plane approach has been touted, technical and patient factors can limit this approach. We developed a caudad-to-cephalad out-of-plane approach and hypothesized that it would decrease pain ratings due to better catheter alignment with the brachial plexus c...
full textUltrasound-guided transversus abdominis plane blocks for laparoscopic appendicectomy in children: a prospective randomized trial.
BACKGROUND The effect of adding transversus abdominis plane (TAP) blocks to local anaesthetic infiltration on morphine consumption and postoperative pain in children undergoing laparoscopic appendicectomy is unknown. METHODS After random allocation, 93 children aged 7-16 were randomized to receive ultrasound-guided TAP blocks placed before surgery or not (control). All subjects had port sites...
full textUltrasound-guided interscalene blocks.
nesthesiologists routinely use peripheral nerve blocks as an alternative or an adjunct to general anesthesia in addition to postoperative analgesia for a wide variety of procedures. More recently, emergency physicians have also begun using regional techniques in lieu of procedural sedation for a wide variety of extremity procedures such as reduction of shoulder dislocation.1 The goal of a perip...
full textUltrasound-guided Subcostal Transversus Abdominis Plane Block
International Journal of Ultrasound and Applied Technologies in Perioperative Care, January-April 2010;1(1):9-12 9 Ultrasound-guided Subcostal Transversus Abdominis Plane Block 1Niraj G, 1A Kelkar, 2R Powell 1Specialist Registrar, Department of Anaesthesia, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK 2Consultant, Department of Anaesthesia, Leicester General Hospital, Gwen...
full textUltrasound-guided transversus abdominis plane catheters and ambulatory perineural infusions for outpatient inguinal hernia repair.
BACKGROUND AND OBJECTIVES Transversus abdominis plane (TAP) blocks anesthetize the lower abdominal wall, and TAP catheters have been used to provide prolonged postoperative analgesia after laparotomy. The use of TAP catheters on an outpatient basis has not yet been described. We present our experience with ultrasound-guided TAP perineural catheter insertion and subsequent management of ambulato...
full textMy Resources
Save resource for easier access later
Journal title:
anesthesiology and pain medicineجلد ۵، شماره ۶، صفحات ۰-۰
Hosted on Doprax cloud platform doprax.com
copyright © 2015-2023