• A & A case reports · Dec 2017

    Case Reports

    Combined Selective Nerve Blockade and Local Infiltration Analgesia in a Total Shoulder Arthroplasty Patient With Chronic Pain and Severe Restrictive Lung Disease: A Case Report.

    • Jason K Panchamia, David A Olsen, Joaquin Sanchez-Sotelo, and Adam W Amundson.
    • From the Department of Anesthesiology and Perioperative Medicine and Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
    • A A Case Rep. 2017 Dec 15; 9 (12): 360-363.

    AbstractInterscalene brachial plexus block is considered the most complete postoperative analgesia after total shoulder arthroplasty. Interscalene brachial plexus block-induced ipsilateral hemidiaphragmatic paralysis may not be tolerated in patients with preexisting pulmonary disease. Selective distal nerve blocks avoid the risk of phrenic nerve block; however, they may provide incomplete analgesia to the glenohumeral joint. We report a case of combined selective suprascapular and axillary nerve blockade in combination with local infiltration analgesia in a patient with severe lung disease undergoing total shoulder arthroplasty. This case highlights the local infiltration analgesia technique of the shoulder joint and current diaphragm-sparing regional anesthesia blocks.

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