- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Normal saline washout bolus may reverse effects of phrenic nerve paralysis during interscalene nerve block
Patients undergoing shoulder surgeries are often given an interscalene nerve block prior to the surgery. This block is a type of regional anesthesia that has been shown to improve postoperative pain outcomes. However, it is associated with a rare but serious complication, especially in patients with a history of lung impairment or comorbidities, called phrenic nerve paralysis. In phrenic nerve paralysis, the one or both sides of the diaphragm stop working, leading to significant difficulty breathing and possibly death.
Researchers at Stanford University have looked at whether using a large volume normal saline washout bolus through a pre-existing interscalene catheter would help to reverse the effects of phrenic nerve paralysis. Led by Mariam Sarwary, MD, the investigators also tried to determine the timeframe needed for this technique to take effect before attempting other rescue efforts.
Twenty adult patients undergoing elective primary total shoulder arthroplasty were enrolled in the study and received standard ultrasound-guided interscalene nerve block catheters and analgesia. Digital spirometer was used to determine baseline and postoperative lung function. Patients were then randomly selected to either receive a saline washout or not. Lung assessments were conducted again at specified intervals. The researchers observed a statistically significant improved outcome in forced vital capacity (FVC), a measure of exhaled air, in the study group at 30 minutes after the intervention.
Past studies have looked at how to reverse phrenic nerve palsy, but Dr. Sarwary noted that this is the first double-blinded, randomized control study to show a clinical improvement in FVC at 30 minutes and the study supports evidence that changes in FVC are most sensitive to phrenic nerve function.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751