Upload
olivia-cobb
View
217
Download
0
Tags:
Embed Size (px)
Citation preview
ANESTHESIA FOR SHOULDER PROCEDURES: THE
INTERSCALENE BRACHIAL PLEXUS BLOCK
Shannon Bachman RN, BSN, SRNA
York College of Pennsylvania/ WellSpan Health Nurse Anesthesia Program
Class of 2015
ObjectivesBrief nod to Alon P.
Winnie Interscalene Brachial
Plexus Block vs. General Anesthesia
Ultrasound Guided vs. PNS Technique
Local Anesthetic Volumes
Adverse EventsCase Study:
Interscalene Catheter
Alon P. Winnie
Winnie Technique
ISB vs. GA: The Data
I’m so happy!!!!
Argg blahhh…
ISB vs. GA: The Data
“…with 30% of patients reporting severe pain on the first postoperative day… [may result
in] unplanned overnight admission…”
ISB: PNS vs. Ultrasound guided
Phrenic Nerve
Volume
Volume cont.
Adverse Events #1. Mid Scalene#2. Ant Scalene#5. Phrenic Nerve#6.Brachial Plexus1
2
56
Case report: “…different and sometimes devastating complications have been reported relating to either needle or catheter insertion or to the administration of local anaesthetic.”
References:• Danelli, G., Bonarelli, S., Tognu, A., Ghisi, D., Fanelli, A., Biondini, S.,...Fanelli, G. (2012). Prospective randomized comparison
of ultrasound-guided and neurostimulation techniques for continious interscalene brachial plexus block in patients undergoing coracoacromial ligament repair. British Journal of Anaesthesia, 108(6), 1006-1010.
• Gonano, C., Kettner, S. C., Ernstbrunner, M., Schebesta, K., Chiari, A., & Marhofer, P. (2009). Comparison of economical aspects of interscalene brachial plexus blockade and general anaesthesia for arthroscopic shoulder surgery. British Journal of Anaesthesia, 103(3), 428-433.
• Hadzic, A., Williams, B. A., Karaca, P. E., Hobeika, P., Unis, G., Dermksian, J.,...Santos, A. C. (2005). For outpatient rotator cuff surgery, nerve block anesthesia provides surerior same-day recovery ver general anesthesia. Pain and Regional Anesthesia, 102, 1001-1007.
• Jeng, C. L., Torrillo, T. M., & Rosenblatt, M. A. (2010). Complications of peripheral nerve blocks. British Journal of Anaesthesia, 105(51), 97-107.
• Liu, S. S., YaDeau, J. T., Shaw, P. M., Wilfred, S., Shetty, T., & Gordon, M. (2011). Incidence of unintentional intraneural injection and postoperative neurological complications with ultrasound-guided interscalene and supraclavicular nerve blocks. Anaesthesia, 66, 168-174.
• Manavi, M. (2010). Lipid infusion as a treatment for local anesthetic toxicity: A literature review. AANA Journal, 78(1), 69- 78.• McNaught, A., Shastri, U., Carmichael, N., Awad, I. T., Columb, M., Cheung, J.,...McCartney, C. J. (2010). Ultrasound reduces
the minimum effective local anaesthetic volume compared with peripheral nerve stimulation for interscalene block. British Journal of Anaesthesia, 106(1), 124-130.
• Ptaszynski, A. E., Horlocker, T. T., Bacon, D. R., & Rowlingson, J. C. (2006). Alon P. Wimmie, L. Donald Bridenbaugh, Jk., Harold Carron, P. Prithvi Raj, and Jordan Katz: Founding fathers of the American Society of Regional Anesthesia. Regional Anesthesia and Pain Medicine, 31(1), 71-78.
• Riazi, S., Carmichael, N., Awad, I., Holtby, R. M., & McCartney, C. J. (2008). Effect of local anaesthetic volume (20vs 5ml) on the efficacy and respiratory consequences of ultrasound-guided interscalene brachial plexus block. British Journal of Anaesthesia, 101(4), 549-556.
• Verela, H., & Burns, S. M. (2010). Use of lipid emulsions for treatment of local anesthetic toxicity: A case report. American Association of Nurse Anesthetists , 78(5), 359-364.
• Winnie, A. P. (1970). Interscalene Brachial Plexus Block. Anesthesia and Analgesia, 49(3), 455-466. • Yanovski, B., Gaitni, L., Volodarski, D., & Ben-David, B. (2012). Catastrophic complication of an interscalene catheter for
continious peripheral nerve block analgesia. Anaesthesia, 67, 1166-1169. • Yauger, Y. J., Bryngelson, J. A., Donohue, K., Lawhorn, L. A., Pitcher, B. M., Schoneboom, B. M., & Watts, D. D. (2010). Patient
outcomes comparing CRNA-admnistered peripheral nerve blocks and general anesthesia: A retrospective chart revew in a US Army same-day surgery center. American Association of Nurse Anesthesia, 78(3), 215-220.