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EVALUATION OF 24-HOUR ANALGESIC EFFECT OF COMBINED US-GUIDED INTERSCALENE BRACHIAL PLEXUS BLOCK, SUPRASCAPULAR NERVE BLOCK AND AXILLARY NERVE BLOCK: PROSPECTIVE CASE SERIES
Author(s):
Zils, V.
,
Zils, V.
Affiliations:
,
Golubovska, I.*
Affiliations:
Hosptal of Traumatology and Orthopaedics, Department of Anesthesiology and Intensive Care, Riga, Latvia
Miscuks, A.
Miscuks, A.
Affiliations:
ESRA Academy. Golubovska I. Sep 13, 2017; 190947
Topic: Humerous and Elbow Surgery
Iveta Golubovska
Iveta Golubovska

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Abstract
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Background and Aims:

Interscalene brachial plexus block is the cornerstone of analgesia for invasive shoulder procedures and provides dense intraoperative and short-term postoperative anesthesia and analgesia. On the other hand, suprascapular and axillary nerve blocks ensure better analgesia 24 hours after surgery. The aim of this study was to evaluate a 24-hour effect of combined US - guided interscalene brachial plexus block, suprascapular nerve block and axillary nerve block in patients undergoing shoulder arthroplasty.

Methods:

Seven patients undergoing elective shoulder arthroplasty received US-guided interscalene brachial plexus block, suprascapular nerve block and axillary nerve block before the operation, using 0.375% ropivacaine. The primary outcome was pain score during 24 hours after the operation, the secondary outcome was to evaluate sleep disturbance and patient satisfaction due to shoulder pain during the first night. All patients received multimodal analgesia with i/v paracetamol, p/o arcoxia and i/v metamizol after the operation. Morphine 10 or 30 mg p/o was used as rescue analgesic.

Results:

All blocks provided fast onset and adequate intra and postoperative anesthesia and analgesia. Mean VAS was 1.47 during first 24 hours. Only one patient was disturbed by VAS 4 pain at night 12 hours after the operation and received rescue opioid. One patient was dissatisfied with early postoperative period.

Conclusions:

Combined US - guided interscalene brachial plexus block, suprascapular nerve block and axillary nerve block may provide good quality postoperative analgesia during 24 hours after the operation.

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