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Postoperative neurological symptoms following arthroscopic shoulder surgery with interscalene block: an exploratory secondary analysis of pooled randomized controlled trial data.
Frost, Samantha; Rodrigues, Daniel; Amadeo, Ryan J J; Wolfe, Scott; Funk, Faylene; Ferguson, Celeste; Brown, Holly; MacDonald, Peter; Dufault, Brenden; Mutter, Thomas Charles.
Afiliación
  • Frost S; Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Rodrigues D; Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Amadeo RJJ; Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Wolfe S; Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Funk F; Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Ferguson C; Orthopedics, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Brown H; Orthopedics, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • MacDonald P; Orthopedics, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Dufault B; George and Fay Yee Centre for Health Care Innovation, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
  • Mutter TC; Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada tmutter@hotmail.com.
Reg Anesth Pain Med ; 48(11): 553-560, 2023 11.
Article en En | MEDLINE | ID: mdl-37295793
OBJECTIVE: Postoperative neurological symptoms (PONS) are recognized complications of regional anesthesia and orthopedic surgery. We aimed to better characterize prevalence and potential risk factors in a homogeneous population of randomized, controlled trial participants. METHODS: Data were pooled from two randomized controlled trials of analgesia after interscalene block with perineural or intravenous adjuvants (NCT02426736, NCT03270033). Participants were at least 18 years of age and undergoing arthroscopic shoulder surgery at a single ambulatory surgical center. PONS were assessed by telephone follow-up at 14 days and 6 months postoperatively, and defined as patient report of numbness, weakness, or tingling in the surgical limb, alone or in combination, and regardless of severity or etiology. RESULTS: At 14 days, PONS occurred in 83 of 477 patients (17.4%). Among these 83 patients, 10 (12.0%) continued to have symptoms a half-year after surgery. In exploratory univariate analyses, no patient, surgical or anesthetic characteristics were significantly associated with 14-day PONS except for lower postoperative day 1 Quality of Recovery-15 questionnaire total score (OR 0.97 (95% CI, 0.96 to 0.99), p<0.01). This result was driven largely by the emotional domain question scores (OR 0.90 95% CI 0.85 to 0.96, p<0.001). Report of all three of numbness, weakness and tingling at 14 days vs other 14-day symptom combinations was associated with persistent PONS at 6 months (OR 11.5 95% CI 2.2 to 61.8, p<0.01). CONCLUSION: PONS are common after arthroscopic shoulder surgery performed with single injection ultrasound-guided interscalene blocks. No definitive mitigating risk factors were identified.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Ortopédicos / Bloqueo del Plexo Braquial Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Humans Idioma: En Revista: Reg Anesth Pain Med Asunto de la revista: ANESTESIOLOGIA / NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Ortopédicos / Bloqueo del Plexo Braquial Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Humans Idioma: En Revista: Reg Anesth Pain Med Asunto de la revista: ANESTESIOLOGIA / NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido