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Background and Aims Short-term hypertension (HT) after Interscalene block (ISB) has been reported in quite few studies (1). In addition to the known side effects of HT, increased surgical hemorrhage may disrupt visual clarity. Therefore, the present study aimed to review the incidence and associated risk factors of hemodynamic changes after ISB using 15 mL of 0.375% bupivacaine for arthroscopic shoulder surgery in the lateral decubitus position.
Methods The follow-up forms of anesthesia, medical records of adult patients without HT were evaluated retrospectively. Systolic and diastolic pressure, heart rate, and peripheral oxygen saturation (SpO2) were recorded before and at five-minute intervals after block performance and during surgery.
Results A total of 99 patients were recruited, and all of them were sedated with midazolam and fentanyl prior to needle insertion. At the 30th minute after ISB before surgery, a 20% increase was observed in 12.1% of patients, compared to the baseline blood pressure (BP). Systolic arterial pressure was found to be >140 mmHg in 7.07% and >180 mmHg in 2.02% of the patients. No differences in heart rate and SpO2 were noted. Antihypertensive medication was administered to 2.02% of patients despite sedation with dexmedetomidine/remifentanil infusion. Such features as age, comorbidities, duration of surgery, and gender had no statistically significant effect on HT (p>0.05).
Conclusions Some spread of local anesthetic after ISB would cause a blockade of carotid sinus baroreceptors leading to an increase in BP. This should be considered in patients with cardiovascular diseases or poorly controlled HT, especially in awake patients under regional anesthesia.
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