@article{3178775,
    title = "Ultrasound-Guided Interscalene Brachial Plexus Nerve Block With an
Ultralow Volume of Local Anesthetic for Post-Thoracotomy Shoulder Girdle
Pain",
    author = "Saranteas, Theodosios and Alevizou, Anastasia and Sidiropoulou, Tatiana and and Mavrogenis, Andreas and Tomos, Periklis and Florou, Panagiota and and Papadimos, Thomas and Kostopanagiotou, Georgia",
    journal = "Journal of Cardiothoracic and Vascular Anesthesia",
    year = "2018",
    volume = "32",
    number = "1",
    pages = "312-317",
    publisher = "W B SAUNDERS CO-ELSEVIER INC",
    issn = "1053-0770, 1532-8422",
    doi = "10.1053/j.jvca.2017.04.043",
    keywords = "shoulder; interscalene brachial plexus nerve block; thoracotomy",
    abstract = "Objectives: To evaluate the efficacy of ultrasound-guided interscalene
nerve block using an ultralow volume of local anesthetic (5 mL of
ropivacaine, 0.75%) for the management of post-thoracotomy shoulder
girdle pain.
Design: Open-cohort, prospective, single-center study.
Setting: University hospital.
Interventions: Patients with post-thoracotomy shoulder girdle pain
(visual analog scale [VAS] >= 5) received an ultrasound-guided
interscalene nerve block.
Measurements and Main Results: Thirty minutes after block
implementation, the VAS was used to quantify pain across the shoulder
girdle. The index (I) was calculated to indicate improvement of pain as
follows:
I = VAS before interscalene nerve block VAS after interscalene nerve
block/VAS before interscalene nerve block x 100
Nerve bocks resulting in I >= 75% were considered excellent. Total
tramadol consumption 36 hours after nerve blocks, patients’
satisfaction, and complications related to the procedure also were
assessed. Patients were segregated in the following 2 groups: group A,
which comprised patients with pain in the shoulder area (glenohumeral
and acromioclavicular joints) (n = 30), and group B, which comprised
patients with pain in the scapula (n = 17). I was significantly greater
in group A (88.3% +/- 14%) than in group B (43.2% +/- 22%). In
groups A and B, 90% and 11% of patients, respectively, demonstrated
excellent pain control. Total tramadol consumption in group A, 25
(0-100) mg, was significantly less that of group B, 250 (150-500) mg.
Patients’ satisfaction also was significantly higher in group A compared
with group B. No complications were recorded.
Conclusions: Ultrasound-guided interscalene nerve block can
substantially alleviate post-thoracotomy pain in the shoulder but not in
the scapular area. (C) 2018 Elsevier Inc. All rights reserved."
}