RAPM Focus

Episode 22: Rate of occurrence of respiratory complications in patients who undergo shoulder arthroplasty with a continuous interscalene brachial plexus block and associated risk factors.


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RAPM Editor-in-Chief Brian Sites, MD, joins Lei Xu, MD, and Ed Mariano, MD, MAS, FASA, FASRA, two

coauthors of “Rate of occurrence of respiratory complications in patients who undergo shoulder
arthroplasty with a continuous interscalene brachial plexus block and associated risk factors,” first
published in May 2023.
Dr. Xu is a clinical assistant professor in the department of anesthesiology at Stanford. She received her
medical degree from Stanford before completing her residency in anesthesiology at the University of
California San Francisco, and then a fellowship in regional anesthesia and acute pain medicine at
Stanford. She is interested in the application of regional anesthesia outside the operating room. Her
research interests include studying the functional outcomes of clinical pathways that include regional
anesthesia in the primary arthroplasty in acute trauma populations.
Dr. Mariano is a professor and senior vice chair in the department of anesthesiology at Stanford. He has
developed techniques and patient care pathways to improve post-operative pain, patient safety, and
other outcomes, and has published over 250 peer-reviewed articles. He has held leadership positions in
the California Society of Anesthesiologists, American Society of Anesthesiologists, American Society of
Regional Anesthesia and Pain Medicine, and multiple journal editorial boards.
In their retrospective observational study, over 1,000 patients were evaluated undergoing total shoulder
replacement with a continuous interscalene block. Respiratory complications were categorized into four
groups: none, mild, moderate, and severe. Interscalene blocks are important to the success of these
surgeries, but there remain concerns about respiratory morbidity.
*The purpose of this podcast is to educate and to inform. The content of this podcast does not
constitute medical advice, and it is not intended to function as a substitute for a healthcare
practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of
the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this
podcast. Listeners should also be aware that professionals in the field may have different opinions. By
listening to this podcast, listeners agree not to use its content as the basis for their own medical
treatment or for the medical treatment of others.
Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline.
#interscalenebrachialplexusblock
#interscaleneblock
#respiratorymorbidity
#respiratorycomplications
#arthoplasty
#shoulderarthoplasty

#localanesthetic

#regionalanesthesia
#chronicpain
#anesthesia
#pain
#painmanagement
#MedEd
#medicine

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