Abstract
Background. The role and significance of the technical aspects of interscalene brachial plexus block in the occurrence of sudden arterial hypotension and bradycardia events during shoulder arthroscopy in a semi-sitting position are ambiguous.
 Aim. The study aimed to assess the effect of interscalene brachial plexus block on the incidence of hypotension-bradycardia events during shoulder arthroscopic surgery in adolescents in a semi-sitting position.
 Materials and methods. This retrospective analysis of anesthesia protocols included 288 patients who underwent arthroscopic shoulder surgery in a semi-sitting position under the interscalene brachial plexus block. Regional blockades were performed with neurostimulation in Group 1 (n = 23), neurostimulation and ultrasound navigation without repositioning the needle in Group 2 (n = 70), and neurostimulation and ultrasound navigation with multiple precision repositioning the needle in Group 3 (n = 195).
 Results. Hypotension-bradycardia events were detected in 26 patients out of 288 (9%). There was a statistically significant difference in the frequency of hypotension-bradycardia in all groups: 10 (43.48%) in Group 1, 15 (21.43%) in Group 2, and 1 (0.51%) in Group 3 (p = 0.000). A direct correlation between hypotension-bradycardia episodes and local anesthetic volume (r = 0.405; p 0.05), and Horners syndrome (r = 0.684, p 0.05) was found.
 Conclusions. Interscalene brachial plexus block with a target delivery of low volume of local anesthetic and dual navigation reduces the risk of hypotension-bradycardia. Horners syndrome can be considered an early predictor of hypotension-bradycardia events.
Highlights
The role and significance of the technical aspects of interscalene brachial plexus block in the occurrence of sudden arterial hypotension and bradycardia events during shoulder arthroscopy in a semi-sitting position are ambiguous
The study aimed to assess the effect of interscalene brachial plexus block on the incidence of hypotensionbradycardia events during shoulder arthroscopic surgery in adolescents in a semi-sitting position
Regional blockades were performed with neurostimulation in Group 1 (n = 23), neurostimulation and ultrasound navigation without repositioning the needle in Group 2 (n = 70), and neurostimulation and ultrasound navigation with multiple precision repositioning the needle in Group 3 (n = 195)
Summary
При артроскопических операциях на плечевом суставе в положении полусидя не определена роль технических аспектов выполнения межлестничной блокады плечевого сплетения, предрасполагающих к развитию внезапных эпизодов артериальной гипотонии и брадикардии. Цель — оценить влияние блокады плечевого сплетения межлестничным доступом на развитие эпизодов гипотонии-брадикардии при артроскопических операциях на плечевом суставе в положении полусидя у подростков. Проведен ретроспективный анализ анестезий у 288 пациентов, которым выполняли артроскопические операции на плечевом суставе в положении полусидя в условиях блокады плечевого сплетения межлестничным доступом. Ключевые слова: гипотония-брадикардия; блокада плечевого сплетения межлестничным доступом; артроскопические операции на плечевом суставе; синдром Горнера. ©© K.S. Trukhin, D.V. Zabolotskii , V.A. Koriachkin, O.V. Kuleshov, K.I. Zakharov, A.A. Сherednichenko, A.Yu. Kulikov C linic of High Medical Technologies named after N.I. Pirogov, Saint Petersburg University, Saint Petersburg, Russia; 2 Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia; 3 H.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
