Efficacy of low dose interscalene brachial plexus block on post anesthesia recovery parameters after shoulder surgery

Excellent postoperative pain control plays central role in the outcome of open shoulder surgery which provides early rehabilitation and accelerates functional recuperation. Fifty patients who were candidate for elective shoulder surgery were enrolled in this study. Patients were randomized to two 25-patient groups. One group received morphin sulfate and in the other group small volume Interscalene Brachial Plexus Block [ISBPB] was performed. Pain severity, patient satisfaction scores and post anesthesia recovery parameters were assessed. Patients satisfaction score was significantly improved in ISBPB [P<0.001]. Agitation in ISBPB group was significantly reduced compared to the other group [P: 0.009]. Pain severity score was significantly reduced with ISBPB [P=0.001]. ISBPB did not have any side effects on post anesthesia recovery parameters. Small volume ISBPB may be considered as a suitable technique for reducing intermediate postoperative pain without any effect on post anesthesia care unit parameters and stay in patients undergoing open shoulder surgery

[Comparising effects of lidocaine 2% and bupivacaine 0/25% infiltrating into endotracheal tube's cuff in order to reduce in occurance of cough, bucking and laryngospasm during emergence from anesthesia]

Cough, bucking and laryngospasm during emergence from anesthesia are side effects of endotracheal intubation and associate with increased in intracranial pressure and ischemia of myocardium. We compared effects of Lidocaine 2% and Bupivacaine 0/25% infiltrating into endotracheal tube's cuff in order to reduce in occurance of cough, bucking and laryngospasm during emergence from anesthesia. 95 adult patients [49 in lidocaine group and 46 in bupivacaine group] undergoing elective surgery under general anesthesia inTabriz Zakarya hospital in 2009-2010 enrolled in a double blind randomized clinical trial. Occurance of cough, bucking and laryngospasm during emergence from anesthesia noted and analyzed with SPSS16 with independent-t test. There was no significant difference between lidocaine 2% and bupivacaine 0/25% in reducing occurance of cough, bucking and laryngospasm [appending on duration of surgery] during emergence from anesthesia. Considering important side effects of bupivacaine, such as neurologic and cardiovascular side effects, we do not recommend using bupivacaine 0.25% instead of lidocaine 2% to infiltrate into endotracheal tube's cuff in order to reduce occurance of cough, bucking and laryngospasm during emergence from anesthesia