Interscalene Brachial Plexus Block

CA-2 · II.B.1.a.2

23Sources
6Kept
1Dropped

1 · Find evidence

PubMed query

Every result is a real PMID returned by NCBI. Nothing on this step is generated.

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23 candidate papers · 2 excluded

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Same-day build

Build finished — 6 points drafted. The deck is in draft and needs your review. Open the draft deck done
PubMed query

Runs the tiered searches, drafts one point per included paper, runs the citation gate and builds a draft deck — the steps below, unattended. Same-day build — drafted locally (medgemma:27b), confirmed against each abstract. The deck still lands in draft: nothing here approves anything.

2 · Teaching points

Source

A point with no source will not survive the gate. That is the point of the gate.

7 points

This observational review found that combining ultrasound with nerve stimulation for interscalene blocks provides slightly increased efficacy and decreased side effects compared with ultrasound alone, though the difference is small. PMID 39739068 kept
This meta-analysis found that co-administering bupivacaine and liposomal bupivacaine for interscalene blocks in shoulder surgery reduces opioid consumption on POD 3 and improves pain scores on POD 2, but increases the risk of hoarseness on POD 1 compared to bupivacaine alone or with other adjuvants. PMID 41310439 kept
This randomized trial found that for ASA I or II patients undergoing humeral surgery with an interscalene block, low-dose esketamine (0.2 mg/kg bolus, 0.15 mg/kg/h infusion) improved postoperative day 1 recovery quality and caused less sedation and heart rate reduction than dexmedetomidine. PMID 40351348 kept
This review found that interscalene catheter position can be altered by neck or shoulder movement, such as during physiotherapy, leading to secondary dislocation that causes side effects or loss of effectiveness hours or days after initially correct placement. PMID 38399521 kept
This meta-analysis of six randomized controlled trials found no statistically significant difference between anterior and posterior approaches in complete sensory block rates or time to block completion, so the choice should be based on provider comfort and proficiency rather than expected superiority of either technique. PMID 39551468 kept
This randomized controlled trial found that adding 5 mg of perineural dexamethasone to ropivacaine for interscalene brachial plexus block in shoulder arthroscopy patients did not significantly prolong the duration of analgesia compared to ropivacaine alone. PMID 40401460 kept
This review article highlights evidence that adding the alpha-2 adrenergic agonist dexmedetomidine as an adjunct to interscalene brachial plexus blocks for shoulder surgery improves pain control and patient outcomes compared to traditional techniques. PMID 38106768 — PMID check failed: pubmed 429 for https://eutils.ncbi.nlm.nih.gov/entrez/eutils/esummary.fcgi?db=pubmed&id=38106768&retmode=json&tool=intraop-teaching dropped

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4 · Build the deck

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5 · Question bank

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