Magnetic Resonance Imaging of Interscalene Plexus Block

Launched by PARACELSUS MEDICAL UNIVERSITY · Jun 24, 2014

Keywords

ClinConnect Summary

Background: Interscalene plexus blockade (ISB) is frequently used during surgery of the upper limb. The use of ultrasound has significantly reduced time of onset and total volume of local anesthetics in comparison to nerve localization by stimulators. (1-4) The introduction of this technique has been correlated with decreased volumes of effective local anesthetics from 40 milliliters and more down to 10 milliliters and less.(3-4) As the injection site of ISB is located in close proximity to the anatomical structures of the spinal cord, spread of local anesthetics could potentially cause adv...

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Eligibility criteria

• Inclusion Criteria:
• • Age between 18 and 75 years
• • Surgery of the shoulder (shoulder arthroscopy, open shoulder joint surgery, rotator cuff surgery, tendon transfer, shoulder arthroplasty, humerus fracture surgery)
• • Patients willing to undergo magnetic resonance imaging prior to surgery
• • Informed consent to participate in the study
• • American Society of Anesthesiologists physical score I, II or III
• Exclusion Criteria:
• • Refusal to participate in the study
• • Inability to understand the study protocol due to language barrier
• • Serious cardiac or pulmonary disease such as decompensated heart failure, recent myocardial infarction (less than one month in the past), heart block greater than 2nd degree, obstructive sleep apnea and chronic obstructive lung disease greater than 2nd degree
• • renal impairment with an calculated glomerular filtration rate below 60ml/min
• • Hypersensitivity to ropivacaine or gadolinium or other contraindications against peripheral nerve blocks
• • Chronic opioid usage greater than 15 mg oral morphine equivalents daily, the daily use of adjunctive pain medications (gabapentins, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors)
• • Schizophrenia or bipolar disorders, uncontrolled anxiety, claustrophobia
• • Peripheral neuropathy
• • Hepatic or renal impairment
• • Ongoing illicit drug or alcohol abuse
• • Metal implants or other contraindications for magnetic resonance imaging
• • Coagulopathy
• • Participation in additional clinical trials within 4 weeks before screening
• • Hearing impairment
• • Pregnancy