European journal of anaesthesiology
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Randomized Controlled Trial
Randomised comparison between superior trunk and costoclavicular blocks for arthroscopic shoulder surgery: A noninferiority study.
Superior trunk block (STB) provides noninferior analgesia to the interscalene block and reduces the risk of hemidiaphragmatic paralysis (HDP). Recently, supraclavicular spreading has also been shown to occur during costoclavicular block (CCB), presenting as an alternative analgesic technique for shoulder surgery. ⋯ Clinical Trial Registry of Korea (KCT0005822, principal investigator: Boohwi Hong) on 25 January 2021 ( https://cris.nih.go.kr ).
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Potent inhaled anaesthetics are halogenated hydrocarbons with a large global warming effect. The use of fluorinated hydrocarbons (most are not anaesthetics) are being restricted but volatile anaesthetics have been exempted from legislation, until now: the EU has formulated a proposal to ban or at least severely restrict the use of desflurane starting January 2026. ⋯ Of note, banning or severely restricting the use of one anaesthetic agent should not distract the user from sensible interventions like reducing fresh gas flows and developing technology to capture and recycle or destroy the wasted potent inhaled anaesthetics that we will continue to use. We call to join efforts to minimise our professional environmental footprint.
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Selectively locating and blocking the individual trunks of the brachial plexus with small volumes of local anaesthetic, a selective trunk block (SeTB), may produce anaesthesia of the entire upper extremity except for the T2 dermatome. ⋯ SeTB produces sensorimotor blockade of the entire upper extremity, causes ipsilateral HDP, and is effective as the sole anaesthetic for surgery from the proximal humerus to the hand.