Document Detail


The perioperative effect of increased body mass index on peripheral nerve blockade: an analysis of 528 ultrasound guided interscalene blocks.
MedLine Citation:
PMID:  22248763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Obese patients can pose a unique perioperative anesthetic challenge, making regional anesthetic techniques an intriguing means of providing analgesia for this population. Ultrasound guidance has been touted recently as being beneficial for this population in which surface landmarks can become obscured. In this study, the effect of increased Body Mass Index (BMI) on ultrasound guided interscalene peripheral nerve blockade is investigated.
MATERIAL AND METHODS: This study is a retrospective review of 528 consecutive patients who received preoperative ultrasound-guided interscalene nerve blocks at the University of Wisconsin Hospital and Clinics. We examined the association between BMI and the following parameters: time required for block placement; presence of Postoperative Nausea and Vomiting (PONV); postoperative Post Anesthesia Care Unit (PACU) pain scores; volume of local anesthetic injected; acute complications; and opioid administration preoperatively, intraoperatively, and postoperatively. Univariate and multivariate least squares and logistic regression models were used.
RESULTS: An elevated BMI was associated with an increased: time required for block placement (p-value=0.025), intraoperative fentanyl administration (p-value<0.001), peak PACU pain scores (p-value<0.001), PACU opioid administration (p-value<0.001), PACU oral opioid administration (p-value<0.001), total PACU opioid administration (p-value<0.001) and incidence of PACU nausea (p-value=0.025)
CONCLUSIONS: Ultrasound guided interscalene nerve blocks for perioperative analgesia can be safely and effectively performed in the obese patient but they may be more difficult to perform and analgesia may not be as complete.
Authors:
Kristopher Schroeder; Adin-Cristian Andrei; Meghan J Furlong; Melanie J Donnelly; Seungbong Han; Aimee M Becker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista brasileira de anestesiologia     Volume:  62     ISSN:  1806-907X     ISO Abbreviation:  Rev Bras Anestesiol     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2012-01-17     Completed Date:  2012-09-25     Revised Date:  2014-02-05    
Medline Journal Info:
Nlm Unique ID:  0401316     Medline TA:  Rev Bras Anestesiol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  28-38     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Editora Ltda. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Body Mass Index*
Female
Humans
Male
Middle Aged
Neck Muscles
Nerve Block / methods*
Obesity*
Pain, Postoperative / prevention & control*
Peripheral Nerves / ultrasonography*
Retrospective Studies
Ultrasonography, Interventional*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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