title: An analysis of 1505 consecutive patients receiving continuous interscalene analgesia at home: a multicentre prospective safety study.
abstract: Continuous interscalene brachial plexus block has been shown to be the most effective analgesic technique following shoulder surgery; however, its use is uncommon due to logistical and safety concerns related to ambulatory administration. We prospectively studied 1505 consecutive patients undergoing shoulder surgery who received continuous interscalene analgesia at home. Catheter removal was by the patient between postoperative days two and five. There were no major complications although 27% of patients reported mild dyspnoea, 13% hoarseness and 7% dysphagia. Twelve percent sought medical advice and 2% reported technical issues with the pump or tubing. Complications and technical issues were associated with patient age; weight; use of ultrasound or concomitant nerve stimulation as the endpoint for final needle tip position; local anaesthetic placement via the catheter or needle; whether a catheter-related intervention for pain relief was required in the recovery area; and the type of ambulatory pump. We conclude that this study supports the safety of this underused analgesic technique.
authors: Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.|Auckland Southern Cross Hospital Group, Auckland, New Zealand.
authors: M J
authors: MJ
authors: Fredrickson
authors: Auckland Southern Cross Hospital Group, Auckland, New Zealand.
authors: P
authors: P
authors: Leightley
authors: Auckland Southern Cross Hospital Group, Auckland, New Zealand.
authors: A
authors: A
authors: Wong
authors: Auckland Southern Cross Hospital Group, Auckland, New Zealand.
authors: M
authors: M
authors: Chaddock
authors: Auckland Southern Cross Hospital Group, Auckland, New Zealand.
authors: A
authors: A
authors: Abeysekera
authors: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors: C
authors: C
authors: Frampton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D065527:Brachial Plexus Block / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012782:Shoulder / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local