Interscalene block for postoperative analgesia using only ultrasound guidance: the outcome in 200 patients.
OBJECTIVE
To report the results of single and continuous interscalene blocks (ISB) performed using ultrasound (US) guidance only.


METHODS
Prospective, observational study.


METHODS
Operating room of a university-affiliated orthopaedic hospital.


METHODS
200 ASA physical status I, II, and III patients undergoing shoulder or elbow surgery.


METHODS
Single or continuous ISB were placed using US guidance only. All blocks were performed by anesthesiology residents and supervised by faculty anesthesiologists.


METHODS
Success rate and frequency of untoward events such as needle paresthesia, vessel puncture, infection, and persistent neurologic deficits were prospectively recorded.


RESULTS
99% of patients reported sensory and motor changes in the distribution of the brachial plexus and postoperative pain scores <or= 2. The rates of needle paresthesia and vessel puncture were 6% and 1%, respectively. Two patients (1%) reported transient neurologic deficits. No signs or symptoms of infection or intravascular injection were noted. There were also no permanent neurologic deficits.


CONCLUSIONS
In this group of 200 consecutive patients, the success rate for postoperative analgesia using US guidance only was 99%. Untoward events such as needle paresthesia and persistent neurologic deficits were lower than existing data on nerve stimulation and paresthesia techniques. Ultrasound can be successfully used as a "stand alone" method to perform ISB.
Davis
Jennifer J
JJ
Department of Anesthesiology, University of Utah Orthopaedic Center, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA.
Swenson
Jeffrey D
JD
Greis
Patrick E
PE
Burks
Robert T
RT
Tashjian
Robert Z
RZ
D000328:Adult; D001917:Brachial Plexus; D004550:Elbow / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D010292:Paresthesia / Q000209:etiology; D011446:Prospective Studies; D012782:Shoulder / Q000601:surgery; D018084:Ultrasonography, Interventional / Q000379:methods*