• J Coll Physicians Surg Pak · Oct 2022

    Evaluation of the Effect of Interscalene Brachial Plexus Block on Intracranial Pressure Using Optic Nerve Sheath Diameter and Internal Jugular vein Collapsibility Index.

    • Oguz Gundogdu and Onur Avci.
    • Department of Anaesthesiology and Reanimation, School of Medicine, Cumhuriyet University, Sivas, Turkey.
    • J Coll Physicians Surg Pak. 2022 Oct 1; 32 (10): 1249-1254.

    ObjectiveTo determine the effect of single-shot interscalene brachial plexus (ISBP) block on intracranial pressure (ICP) by evaluating the extravascular volume effect of the medicine on the internal jugular vein (IJV).Study DesignInterventional study.Place And Duration Of StudyDepartment of Anaesthesiology and Reanimation, Sivas Cumhuriyet University, Sivas, Turkey, from January to June 2022.MethodologyThirty-four patients were included in this prospective clinical study. All patients had single-shot ISBP block with 25 ml of local anaesthetic. Optic nerve sheath diameter (ONSD), maximum (Dmax) and minimum (Dmin) diameters of IJV and IJV collapsibility index (IJV-CI) were recorded before the block (basal), 20 minutes, and 60 minutes after the block.ResultsTwenty-nine patients had higher ONSD values at 60th minute compared to their basal values. There were negative correlations between the changes of ONSD and IJVCI (r=0.616, p<0.001) and ONSD and Dmax (r=0.581, p<0.001) in time period between basal and 20th minute. There were negative correlations between the changes of ONSD and IJVCI (r=0.518, p=0.002), ONSD and Dmax (r=0.664, p<0.001) in time period between basal and 60th minute.ConclusionSingle-shot ISBP block with 25 ml of local anaesthetic may be a factor that increases ICP. Repeated intraoperative ONSD measurements are recommended in patients operated with ISBP block.Key WordsInterscalene Brachial Plexus Block, Intracranial pressure, Optic nerve sheath diameter, Internal jugular vein collapsibility index.

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