Onset and recovery of ultrasound guided out-of-plane versus in-plane interscalene block in arthroscopic shoulder surgery

• Published in: Ain-Shams journal of anesthesiology Vol. 12; no. 1; pp. 1 - 8
• Main Authors: Samir, Ghada M., Ghallab, Mahmoud Abd El-Aziz
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 05-05-2020; Springer Nature B.V; SpringerOpen
• Subjects: Airway management; Anesthesia; Anesthesiology; Arthroscopy; Catheters; Critical Care Medicine; Duration of postoperative analgesia; Electrocardiography; In-plane block; Intensive; Medicine; Medicine & Public Health; Onset of sensory block; Original Article; Out-of-plane block; Pain; Shoulder; Surgery; Ultrasonic imaging; Onset of sensory block; Duration of postoperative analgesia; Out-of-plane block; In-plane block
• ISSN: 2090-925X; 1687-7934; 2090-925X
• DOI: 10.1186/s42077-020-00062-1

Background
The aim of this study was to assess the out-of-plane versus the in-plane approaches for the interscalene brachial plexus block, as regards the performance time, the onset, the progression and the recovery of sensory block, the onset and progression of the motor block as well as, the postoperative pain score, and the duration of analgesia for arthroscopic shoulder surgery. A total of 60 patients of American Society of Anesthesiologists (ASA) physical status I-II were randomly divided to receive either the in-plane approach (group I), or the out-of-plane approach (group O).
Results
The block performance time was statistically significant shorter in group O. The onset of sensory block was statistically significant faster in group O. The progression of sensory block over the first 20 min was statistically significant fast for C
5
and C
6
nerve roots in group O. The motor block showed statistically and clinically significant rapid onset and progression in group O. All patients in group O and group I felt no pain in the post-anesthesia care unit (PACU), and the first call for analgesia was at 24 h in both groups.
Conclusion
The out-of-plane approach offers short performance time, rapid onset and progression of sensory and motor blocks, as well as postoperative analgesic effect lasting for 24 h in arthroscopic shoulder surgery.