Effect of Interscalene Block on Ventilatory Function

Pierre and Marie Curie University70 enrolled

Overview

Interscalene block with local anesthetic impairs ventilation (unilateral diaphragmatic dysfunction). Single injection of local anesthetic induced transitory dysfunction (\< 24h). The investigators hypothesized that continuous interscalene block would prolonged ventilatory impairment

Unilateral pulmonary dysfunction occured after interscalene block due to phrenic nerve paralysis. This reduction induced vital capacity alteration and peek flow reduction.Several studies analysed dysfunction recovery duration after single injection using short (lidocaine)or intermediate (ropivacaine, bupivacaine)local anesthetic drug. Because continuous infusion prolonged block duration, phenic nerve may be also prolonged. However no study with continuous interscalene infusion have been performed for this dysfunction.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Respiratory Depression Anesthesia Morbidity Block

Interventions

ropivacaine 2 mg/mlDRUG

single

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * surgery : scheduled for elective shoulder surgery * available for 1 month of follow up * physical status : 1, 2, 3 Exclusion Criteria: * body mass index \> 35 * contraindication for interscalene block (local sepsis, bleeding, allergy, peripheral neuropathy) * vital capacity less than 1.5 liters * cardiac or renal insufficiency * physical status \>3, pregnant, weigh less than 50 kg

Locations (1)

Centre hospitalier La Pitié Salpetriere

Paris, Île-de-France Region, France

Outcomes

Primary Outcomes

Reduction of the pulmonary forced vital capacity

A 25 % reduction of the pulmonary forced vital capacity is expected and measured using spirometer

Time frame: Day 2

Secondary Outcomes

Reduction of the pulmonary maximum forced expiratory flow

Outcome measure was performed using a spirometer

Time frame: Day 2

Morphine consumption

Additional morphine administration for pain management (morphine intravenous : 1 mg every 7 min when necessary, pain score \> 3/10)

Time frame: Day 2

Pain score at rest and motion

Outcome Measure using a visual analog scale (0 to 10)

Time frame: Day 2

Data from ClinicalTrials.gov

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