A retrospective review of interscalene nerve blockade for shoulder surgery in the pediatric population. | [Anaesthesia, Pain and Intensive Care • 2014]

Author(s):

1. Dana Marie Aminian: Department of Anesthesiology & Pain Medicine, Nationwide Children`s Hospital and The Ohio State University Medical Center, Columbus, Ohio, USA

2. Tarun Bhalla: Department of Anesthesiology & Pain Medicine, Nationwide Children`s Hospital and The Ohio State University Medical Center, Columbus, Ohio, USA

3. Kelly Sprague: Department of Anesthesiology & Pain Medicine, Nationwide Children`s Hospital and The Ohio State University Medical Center, Columbus, Ohio, USA

4. Walter Samora: Department of Orthopedic Surgery, Nationwide Children`s Hospital and The Ohio State University, Columbus, Ohio, USA

5. Diane Von Stein: Department of Orthopedic Surgery, Nationwide Children`s Hospital and The Ohio State University, Columbus, Ohio, USA

6. Joseph D. Tobias: Department of Pediatrics, Nationwide Children`s Hospital and The Ohio State University, Columbus, Ohio, USA

Abstract:

Purpose: To retrospectively investigate the efficacy of interscalene nerve blockade in reducing postoperative pain and minimizing inpatient hospital admission after shoulder surgery in the pediatric population. Methodology: Thirty-four consecutive patients undergoing shoulder surgery under general anesthesia both with and without the addition of an interscalene nerve block were included in the study. After induction of general anesthesia, those patients receiving regional anesthesia had an interscalene nerve block placed using real-time ultrasonographic guidance with the deposition of 20-30 mL of local anesthetic solution into the interscalene groove. Postoperative pain scores, the use of supplemental analgesic medications, post-anesthesia care unit (PACU) length of stay, hospital course, and any acute or non-acute complications were recorded and evaluated. Results: There were no cardiac events, neuropathies, seizures, pneumothoraces, or other major complications. There was a statistically significant reduction in the pain scores in patients who received an interscalene nerve block versus those who did not. There was also a significant difference found in the need for postoperative inpatient hospital admission. Eleven of the 14 patients (79%) who received a combined general and regional anesthetic technique were discharged home on the day of surgery versus 9 of 20 patients (45%) who did not receive an interscalene block (p = 0.036). Postoperative opioid requirements were significantly reduced in patients receiving an interscalene block within the first six hours of inpatient hospital admission (p = 0.035). There was no difference in PACU length of stay or adverse effects (postoperative nausea and vomiting) between the groups. Conclusion: Interscalene nerve block offers a safe and effective method of providing superior postoperative analgesia and minimizing inpatient hospital admissions in pediatric patients undergoing shoulder surgery.

Page(s): 345-349

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 18, Issue: 4, Year: 2014

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