Department of Anesthesiology and Pain Management, Montefiore Medical Center, 1250 Waters Pl, Tower II, 8th Floor, Bronx, 10461, NY, USA.
Department of Anesthesiology and Perioperative Medicine, UMASS Memorial Medical Center, 119 Belmont St, Worcester, 01605, MA USA.
Best Pract Res Clin Anaesthesiol. 2019 Dec;33(4):553-558. doi: 10.1016/j.bpa.2019.05.006. Epub 2019 Jun 5.
Interscalene brachial plexus block (IBPB) has become a standard practice for perioperative analgesia for shoulder procedures. However, several side effects may occur owing to its anatomic location. We have chosen to evaluate vocal cord paresis and dysphonia following interscalene blocks.
After IRB approval, eight patients undergoing arthroscopic shoulder procedures were recruited into this prospective cohort study. Following informed consent, vocal cords were assessed by standardized fiberoptic evaluation. Subsequently, IBPB was performed under ultrasound (US) guidance. Patients were re-evaluated for vocal cord changes by a repeat fiberoptic assessment one hour following IBPB. Our primary outcome measure was incidence of vocal cord immobility.
No patients had diminished vocal cord motion, dysphonia, or dysphagia.
Although larger studies are required to determine the true incidence of vocal cord paresis following US-guided IBPB, our results suggest that incidence of unwanted nerve blockade other than brachial plexus is much lower than that previously described.
经锁骨上臂丛神经阻滞（IBPB）已成为肩部手术围手术期镇痛的标准方法。然而，由于其解剖位置，可能会出现几种副作用。我们选择评估锁骨下臂丛阻滞后的声带麻痹和声音障碍。
在 IRB 批准后，我们招募了 8 名接受关节镜肩部手术的患者进行这项前瞻性队列研究。在获得知情同意后，通过标准化的纤维光学评估评估声带。随后，在超声（US）引导下进行 IBPB。在 IBPB 后 1 小时，通过重复纤维光学评估对声带变化进行重新评估。我们的主要观察指标是声带运动障碍的发生率。
没有患者出现声带运动减弱、声音嘶哑或吞咽困难。
尽管需要更大的研究来确定超声引导下 IBPB 后声带麻痹的确切发生率，但我们的结果表明，除臂丛神经以外的其他神经阻滞的发生率远低于以前描述的发生率。
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