RT Journal
A1 Singh, Anshu
A1 Kelly, Charles
A1 O’Brien, Travis
A1 Wilson, Jeffrey
A1 Warner, Jon J.P.
T1 Ultrasound-Guided Interscalene Block Anesthesia for Shoulder ArthroscopyA Prospective Study of 1319 Patients
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD November 21
VO 94
IS 22
SP 2040
OP 2046
DO 10.2106/JBJS.K.01418
UL http://dx.doi.org/10.2106/JBJS.K.01418
AB Background: 
  Ultrasound guidance improves the localization of anesthetic placement during regional anesthesia, but a decreased rate of adverse events has not been demonstrated in the current literature. In this large prospective study, we evaluated the safety, efficacy, and patient satisfaction associated with ultrasound-guided interscalene block.Methods: 
  A cohort of 1319 patients undergoing arthroscopic shoulder surgery at an outpatient surgery center was prospectively evaluated. Interscalene blocks were performed by experienced anesthesiologists and trainees with use of ultrasound guidance. Patients were queried by a physician twenty-four hours postoperatively regarding their satisfaction with the interscalene block and were screened for a comprehensive register of minor and major adverse events. Individuals with adverse events were followed until symptoms resolved.Results: 
  Interscalene block was ultimately successful in 99.6% of the cases. A total of thirty-eight adverse events (prevalence, 2.88%) were noted. At the time of the latest follow-up, permanent sequelae were present in three patients (0.23%), all of whom had relevant comorbidities. With regard to patient satisfaction, 99.06% of the respondents were “satisfied” or “very satisfied” with the interscalene block, whereas 0.94% of respondents were unsatisfied. In addition, 97.8% of the patients stated that they would elect to have an interscalene block again in the future.Conclusions: 
  The present study supports the use of ultrasound-guided interscalene block by trained anesthesiologists for well-screened patients undergoing shoulder arthroscopy, given the high rate of patient satisfaction and the low rate of adverse events.Level of Evidence: 
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.