[Parascalene block for shoulder arthroscopic surgery].

OBJECTIVE

To evaluate the effectiveness of a parascalene block of the brachial plexus as the single form of anesthesia for arthroscopic surgery on the shoulder and for postoperative analgesia.

MATERIAL AND METHODS

A parascalene block was performed in 151 ASA I-III patients using a plumb-bob technique with the aid of nerve stimulation and with the needle entering at a point 3 cm cephalad to the clavicle and 0.5-1 cm lateral to (and outside) the sternocleidomastoid muscle. We recorded the success or not of blockade, the incidence of side effects, clinical course during and after surgery, and patient and surgeon satisfaction with the technique.

RESULTS

A full block was achieved in all patients, although 19 (13%) requiered a second puncture. Midazolam was administered to 34 patients for anxiety and 48 required urapidil to normalize blood pressure. Complications (incidental blocks) were rare, transitory, and mild: 6 patients with Claude Bernard-Horner syndrome, 13 with dysphonia due to recurrent nerve blockade, and 1 with diaphragmatic paresis. Postoperative pain was practically nonexistent. Administration of diclofenac as indicated was sufficient for 91.2% of the patients. The remaining 8.8% needed top-up doses. Patients and surgeons assessed the block as excellent.

CONCLUSION

The parascalene technique to provide a brachial plexus block is effective for arthroscopic shoulder surgery.