Acta Ortopédica Mexicana

Mejía-Terrazas GE, Ruiz-Suárez M, Encalada-Díaz IM, Gaspar-Carrillo SP, Valero-González F, Peña-Riveron AA
Total shoulder arthroplasty with interscalene block. Feasibility study
Acta Ortop Mex 2012; 26 (6)

Language: Español
References: 24
Page: 358-361
PDF: 58.18 Kb.

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Introduction: General anesthesia is considered as the technique of choice for shoulder surgery, either alone or combined. We propose to show the feasibility of using guided interscalene block as the single anesthetic technique for total shoulder arthroplasty. Material and methods: Neurostimulation-guided interscalene block plus sedation with dexmedetomidine were used. The following were measured intraoperatively: latency time, intraoperative analgesia, motor block according to Monzo’s scale, success rate, adverse events and complications. The following were measured postoperatively: duration of postoperative analgesia and pain intensity with a visual analogue scale at 6, 12 and 24 hours. Patient satisfaction was also measured. Results: Intraoperative analgesia was appropriate in 100% of patients. Motor block was grade 0 in 76.4% and grade 1 in 23.6%, which is appropriate for surgery. The success rate was 100%. Mean postoperative pain at 6 hours was 0.13 ± 0.54 points in the visual analogue scale; 1.67 ± 1.15 at 12 hours, and 3.15 ± 1.66 points at 24 hours. 54.5% of patients were very satisfied and 45.5% were satisfied. Complications occurred in 18.18%. Conclusion: This type of surgery is feasible with interscalene block plus sedation; it is a safe and efficacious technique.

Key words: block, arthroplasty, shoulder, peripheral nerve block, anesthesia, brachial plexus, pain.