Does Saline Injection Around Phrenic Nerve Reduce Incidence of Diaphragmatic Paresis Following Interscalene Block?
Phrenic Nerve Palsy
About this trial
This is an interventional supportive care trial for Phrenic Nerve Palsy focused on measuring forced expiratory volume in 1 second, forced vital capacity, peak expiratory flow rate, interscalene block, diaphragmatic paresis
Eligibility Criteria
Inclusion Criteria:
- Patients undergoing surgery on shoulder, humerus, or clavicle
Exclusion Criteria:
- Patient refusal
- Allergy to local anaesthesia
- Severe coagulopathy
- Contralateral phrenic nerve palsy
- Local infection
- Moderate to severe pulmonary dysfunction (GOLD II, II, IV)
Sites / Locations
- Adelaide and Meath Hospital, Incorporating National Children Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Group S (saline group)
Group C (control group)
In plane posterior approach will be used with a 50mm short bevel block needle (Braun), advanced through the middle scalene muscle. At the location chosen for interscalene block the needle tip will be positioned anterior to the anterior scalene muscle. At this point 10ml of 0.9% saline will be injected. This will be followed by repositioning of the needle between roots C5 and C6 where 20 ml of 0.25% levobupivicaine will be injected in 5ml increments with intermittent aspiration.
In plane posterior approach will be used with a 50mm short bevel block needle (Braun), advanced through the middle scalene muscle. The needle tip will be positioned between roots C5 and C6 where 20 ml of 0.25% levobupivicaine will be injected in 5ml increments with intermittent aspiration.