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Background and Aims Shoulder surgery causes moderate to severe pain .In this case series we have combined low volume C5,C6 root block with postoperative Erector spinae plane block ( ESPB) and studied the analgesic efficacy,involvement of the diaphragm and other complications after Shoulder surgery.
Methods Thirteen patients undergoing shoulder surgery under general anaesthesia were given C5 -C6 root block with 0.375% ropivacaine 6 to 8 ml before incision. Before extubation ultrasound guided ESPB at T2 was given using 15 ml of 0.375% ropivacaine along with intravenous paracetamol and diclofenac.Ultrasound guided diaphragmatic assessment was done preoperatively and after extubation. Each patient was assessed postoperatively at regular intervals upto 24 hours for visual analogue score and requirement of analgesia.
Results Average visual analogue score (VAS) upto 6 hours was 0, at 12 hours was 0.54, 18 hrs 1.62, 24 hrs 1.92.Rescue analgesics were needed once, in 4 patients (30%) at 12, 13, 14, 16 and in three patients (23%) at 18 hours.The average duration of analgesia was 18 hours. No diaphragm involvement or other complications were noted .
Conclusions C5-C6 root block combined with postoperative ESPB for shoulder surgery reduced the requirement for rescue analgesic, lowered the VAS and spared the diaphragm with no adverse event.
Attachment CamScanner 12-25-2020 22.18.26.pdf
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