Ultrasound-guided interscalene block versus intravenous analgesia and sedation for reduction of first anterior shoulder dislocation.

Abstract

PURPOSE:

This study aims to compare the efficacy of ultrasound-guided interscalene block (US-ISB) with that of intravenous analgesia and sedation (IVAS) in reducing first shoulder dislocation.

MATERIAL AND METHODS:

A prospective study was performed in 66 patients with first anterior shoulder dislocation in emergency department. The patients were divided into a US-ISB (n = 32) group and an IVAS (IVAS n = 34) group. The procedure time (anesthesia, reduction, and hospital times), pain score (before, during, and after reduction), reduction attempts, complications, and patient satisfaction were recorded and compared between the two groups.

RESULTS:

The anesthesia time (P < 0.01) and reduction time (P < 0.01) were shorter and the hospital time (P < 0.01) was longer in the IVAS group than in the US-ISB group. No significant differences in preoperative (P = 0.18) and postoperative (P = 0.27) pain scores were found between the two groups, but the intraoperative score of the US-ISB group was significantly higher than that of the IVAS group. More reduction attempts (P < 0.01) were recorded in the US-ISB group than that in the IVAS group. Complications (P < 0.01) such as nausea, vomiting, headache, and hypoxia occurred more frequently in the IVAS group than in the US-ISB group. No significant difference in patient satisfaction was observed between two groups (P = 0.96).

CONCLUSION:

Compared with IVAS group, US-ISB group reduces the time to discharge and achieves lesser complication. The pain score and reduction attempt are lower in the IVAS group than in the US-ISB group.

• Authors: Liwei Yao, Wenwei Dong, Zeting Wu, Qingzhen Zhao, Haijiao Mao
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 56 Pg. 232-235 (06 2022) ISSN: 1532-8171 [Electronic] United States
• PMID: 35462152 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Local

Topics

• Analgesia (methods)
• Anesthetics, Local (therapeutic use)
• Arthroscopy (adverse effects, methods)
• Brachial Plexus Block (methods)
• Humans
• Pain (complications)
• Pain, Postoperative (drug therapy, prevention & control)
• Prospective Studies
• Shoulder (surgery)
• Shoulder Dislocation (complications, surgery)
• Ultrasonography, Interventional