Document Detail

Scalene regional anesthesia for shoulder surgery in a community setting: an assessment of risk.
MedLine Citation:
PMID:  12004020     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A retrospective review of shoulder procedures using scalene block anesthesia was performed. METHODS: The records of all 218 patients who had undergone scalene block anesthesia over a three-year period at two facilities were retrospectively reviewed. All blocks were performed with use of a standard blunt-needle technique with the patient awake and with use of preoperative nerve stimulation to localize the brachial plexus. RESULTS: Adjunctive general anesthesia was used for 179 (82%) of the 218 patients. Seventy-two patients (33%) required intravenous pain medication immediately on arrival in the recovery room, and twenty-eight blocks (13%) failed. One grand mal seizure, one episode of cardiovascular collapse, and four episodes of severe respiratory distress were noted. Two patients had temporary neurologic injuries that persisted at six weeks. The mean duration of the block was 9 +/- 4.6 hours. Two hundred (92%) of the 218 patients required parenteral narcotics despite the use of scalene block anesthesia. CONCLUSION: Informed consent discussions regarding scalene block anesthesia should include information on the prevalence of complications and the efficacy of the technique.
Stephen C Weber; Ritu Jain
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  84-A     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-10     Completed Date:  2002-06-10     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  775-9     Citation Subset:  AIM; IM    
Sacramento Knee and Sports Medicine and Sutter General Hospital, Sacramento, California 95816, USA.
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MeSH Terms
Aged, 80 and over
Anesthesia, Conduction / adverse effects*
Anesthetics, Local / adverse effects*
Bone Diseases / physiopathology,  surgery*
Hospitals, Community*
Middle Aged
Nerve Block / adverse effects*
Pain Measurement
Postoperative Complications*
Recovery of Function / drug effects,  physiology
Retrospective Studies
Risk Assessment
Shoulder Joint / injuries*,  physiopathology,  surgery*
Reg. No./Substance:
0/Anesthetics, Local
Comment In:
J Bone Joint Surg Am. 2002 Oct;84-A(10):1891; author reply 1892-3   [PMID:  12377926 ]
J Bone Joint Surg Am. 2002 Oct;84-A(10):1891-2; author reply 1892-3   [PMID:  12385286 ]

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