Redefining Limits: Shoulder Disarticulation Under Regional Anaesthesia Alone

Vol 5 | Issue 2 | July-December 2024 | Page 16-19| Vandana Mangal, Momoson Maring Tontanga, Chitra Singh, Tuhin Mistry

DOI: https://doi.org/10.13107/ijra.2024.v05.i02.98

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted: February 18-11-2024; Reviewed: 25-11-2024; Accepted: 02-12-2024; Published: 10-12-2024


Authors: Vandana Mangal [1], Momoson Maring Tontanga [1], Chitra Singh [1], Tuhin Mistry [2]

[1] Department of Anaesthesiology and Critical Care, SMS Medical College, Jaipur, Rajasthan, India.
[2] Department of Anaesthesiology and Perioperative Care, Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, India

Address of Correspondence

Dr. Tontanga Momoson Maring
Department of Anaesthesiology and Critical Care, SMS Medical College, Jaipur, Rajasthan, India.
Email id: drmomoson@gmail.com


Abstract

Shoulder disarticulation following of animal bites is not uncommon and is often performed for various indications, including vascular insufficiency. General anaesthesia is usually the preferred choice in optimized patients, with or without regional anaesthesia. Phantom limb pain is a distressing and frequently encountered condition following limb amputation. In addition to their well-established benefits, nerve blocks not only provide effective perioperative analgesia but may also reduce the incidence of phantom limb pain. In this case, we undertook shoulder disarticulation exclusively under regional anaesthesia, as the patient’s respiratory condition was not optimal for general anaesthesia.

Keywords: Shoulder disarticulation, Regional anaesthesia, Subclavian perivascular block, Superficial cervical plexus block, Pectoserratus plane block.


References


1. Mahajan, A., Luther, A., & Chhabra, A. (2015). Brachial artery injury caused by camel bite. Indian Journal of Vascular and Endovascular Surgery, 2(1), 33. https://doi.org/10.4103/0972-0820.152834
2. Abu-Zidan FM, Hefny AF, Eid HO, Bashir MO, Branicki FJ. Camel-related injuries: Prospective study of 212 patients World J Surg. 2012;36:2384–9
3. Maduri P, Akhondi H. Upper Limb Amputation. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK540962/
4. Donnelly, M. R., & Hacquebord, J. H. (2023). Shoulder level amputation: Forequarter and brachial plexus-level amputation. Operative Techniques in Orthopaedics, 33(3), 101056. https://doi.org/10.1016/j.oto.2023.101056
5. Kilicaslan A, Gok F, Colak TS, Keklicek O, Kucuksen MF. Combined interscalene, superficial cervical plexus and thoracic intertransverse process blocks for surgical anaesthesia of the shoulder disarticulation. Anaesth Rep. 2024;12(1):e12306. Published 2024 May 29. doi:10.1002/anr3.12306
6. Mbabazi P, Mwaniki M, Wambua G, Kagua S, Kamau RW, Daggett J, Nthumba PM. Successful Shoulder Disarticulation under Local Anesthesia in the COVID-19 Era. Plast Reconstr Surg Glob Open. 2023 Sep 13;11(9):e5266. doi: 10.1097/GOX.0000000000005266. PMID: 37711723; PMCID: PMC10499080.
7. Duggappa DR, Rao GV, Kannan S. Anaesthesia for patient with chronic obstructive pulmonary disease. Indian J Anaesth. 2015 Sep;59(9):574-83. doi: 10.4103/0019-5049.165859. PMID: 26556916; PMCID: PMC4613404.
8. Miniato MA, Anand P, Varacallo MA. Anatomy, Shoulder and Upper Limb, Shoulder. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536933/
9. Hamadnalla, H., Elsharkawy, H., Shimada, T. et al. Cervical erector spinae plane block catheter for shoulder disarticulation surgery. Can J Anesth/J Can Anesth 66, 1129–1131 (2019). https://doi.org/10.1007/s12630-019-01421-9
10. Mbabazi P, Mwaniki M, Wambua G, Kagua S, Kamau RW, Daggett J, Nthumba PM. Successful Shoulder Disarticulation under Local Anesthesia in the COVID-19 Era. Plast Reconstr Surg Glob Open. 2023 Sep 13;11(9):e5266. doi: 10.1097/GOX.0000000000005266. PMID: 37711723; PMCID: PMC10499080.


How to Cite this Article: Mangal V, Tontanga MM, Singh C, Mistry T | Redefining Limits: Shoulder Disarticulation Under Regional Anaesthesia Alone | International Journal of Regional Anaesthesia | July-December 2024; 5(2): 16-19 | DOI: https://doi.org/10.13107/ijra.2024.v05.i02.98


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