The Effects of Horner's Syndrome Developing After Interscalene Brachial Plexus Block on Autonomic Nervous Activity

Daegu Catholic University Medical Center

Status: Completed

Conditions: Brachial Plexus Block; Autonomic Imbalance; Horner Syndrome

Treatments: Procedure: Interscalene brachial plexus block; Drug: 0.75% ropivacaine

Study type: Observational

Funder types: Other

Identifiers

NCT03514342

2018-02

Details and patient eligibility

About

This study evaluates the effects of Horner's syndrome on cardiac autonomic nervous activity after interscalene brachial plexus block. Cardiac autonomic nervous activity and bilateral pupil diameters will be measured in a scotopic light condition, 30 minutes after interscalene brachial plexus block under ultrasound guidance and 15 minutes after the subsequent sitting position.

Full description

Stellate ganglia provide sympathetic fibers to the heart. Ipsilateral stellate ganglion block accompanied by interscalene brachial plexus block causes Horner's syndrome presenting with miosis, ptosis, and anhidrosis. The extent of Horner's syndrome can be represented by the difference in pupil diameter between bilateral eyes. Cardiac autonomic nervous activity affected by stellate ganglion block can be measured by calculation of heart rate variability parameters.

Enrollment: 48 patients

Sex: All

Ages: 20 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists physical status 1
• Arthroscopic shoulder surgery under interscalene brachial plexus block

Exclusion criteria

• Coagulopathy
• Infection at the site of brachial plexus block
• Peripheral neuropathy or neurologic sequelae on the operative limb
• Allergy to local anesthetics or history of allergic shock
• Psychiatric diseases
• Patient refusal
• Difficulty communicating with medical personnel
• Arrhythmias
• Ischemic heart disease
• Hypertension
• Diabetes mellitus
• Thyroid dysfunction
• Conduction abnormalities on electrocardiogram
• Electrolyte imbalance
• Medications affecting cardiac conduction
• Contralateral vocal cord palsy
• Contralateral hemidiaphragmatic paresis or paralysis
• Contralateral pneumothorax or hemothorax

Trial design

48 participants in 1 patient group

Interscalene brachial plexus block

Description:

Ultrasound-guided interscalene brachial plexus block with 25 ml to 30 ml of 0.75% ropivacaine

Treatment:

Procedure: Interscalene brachial plexus block

Drug: 0.75% ropivacaine