Perioperative management of interscalene block in patients with lung disease.

Authors

Eric S. Schwenk, Department of Anesthesiology, Thomas Jefferson UniversityFollow
Kishor Gandhi, Rothman Institute, Thomas Jefferson University HospitalFollow
Eugene R. Viscusi, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

1-1-2013

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in Case Reports in anesthesiology.

2013: 986386

The published version is available at DOI: 10.1155/2013/986386. Copyright © Hindawi

Abstract

Interscalene nerve block impairs ipsilateral lung function and is relatively contraindicated for patients with lung impairment. We present a case of an 89-year-old female smoker with prior left lung lower lobectomy and mild to moderate lung disease who presented for right shoulder arthroplasty and insisted on regional anesthesia. The patient received a multimodal perioperative regimen that consisted of a continuous interscalene block, acetaminophen, ketorolac, and opioids. Surgery proceeded uneventfully and postoperative analgesia was excellent. Pulmonary physiology and management of these patients will be discussed. A risk/benefit discussion should occur with patients having impaired lung function before performance of interscalene blocks. In this particular patient with mild to moderate disease, analgesia was well managed through a multimodal approach including a continuous interscalene block, and close monitoring of respiratory status took place throughout the perioperative period, leading to a successful outcome.

Recommended Citation

Schwenk, Eric S.; Gandhi, Kishor; and Viscusi, Eugene R., "Perioperative management of interscalene block in patients with lung disease." (2013). Department of Anesthesiology Faculty Papers. Paper 26.
https://jdc.jefferson.edu/anfp/26

PubMed ID

24369510