Perioperative Management of Interscalene Block in Patients with Lung Disease
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 i...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2013/986386 |
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| author | Eric S. Schwenk Kishor Gandhi Eugene R. Viscusi |
| author_facet | Eric S. Schwenk Kishor Gandhi Eugene R. Viscusi |
| author_sort | Eric S. Schwenk |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-216a84648747495cbbbd1b554792d081 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-216a84648747495cbbbd1b554792d0812025-02-03T05:52:19ZengWileyCase Reports in Anesthesiology2090-63822090-63902013-01-01201310.1155/2013/986386986386Perioperative Management of Interscalene Block in Patients with Lung DiseaseEric S. Schwenk0Kishor Gandhi1Eugene R. Viscusi2Department of Anesthesiology, Jefferson Medical College, Suite 8490, 111 South 11th Street, Philadelphia, PA 19107, USADepartment of Anesthesiology, Jefferson Medical College, Suite 8490, 111 South 11th Street, Philadelphia, PA 19107, USADepartment of Anesthesiology, Jefferson Medical College, Suite 8490, 111 South 11th Street, Philadelphia, PA 19107, USAInterscalene 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.http://dx.doi.org/10.1155/2013/986386 |
| spellingShingle | Eric S. Schwenk Kishor Gandhi Eugene R. Viscusi Perioperative Management of Interscalene Block in Patients with Lung Disease Case Reports in Anesthesiology |
| title | Perioperative Management of Interscalene Block in Patients with Lung Disease |
| title_full | Perioperative Management of Interscalene Block in Patients with Lung Disease |
| title_fullStr | Perioperative Management of Interscalene Block in Patients with Lung Disease |
| title_full_unstemmed | Perioperative Management of Interscalene Block in Patients with Lung Disease |
| title_short | Perioperative Management of Interscalene Block in Patients with Lung Disease |
| title_sort | perioperative management of interscalene block in patients with lung disease |
| url | http://dx.doi.org/10.1155/2013/986386 |
| work_keys_str_mv | AT ericsschwenk perioperativemanagementofinterscaleneblockinpatientswithlungdisease AT kishorgandhi perioperativemanagementofinterscaleneblockinpatientswithlungdisease AT eugenerviscusi perioperativemanagementofinterscaleneblockinpatientswithlungdisease |