{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:04:40Z","timestamp":1793361880411,"version":"4.5.0"},"reference-count":28,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/501100018742","name":"Pan Am Clinic Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018742","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007481","name":"Canadian Anesthesia Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007481","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Manitoba Department of Anesthesiology, Perioperative and Pain Medicine Oversight and Advisory Committee"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2023,3,7]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Postoperative neurological symptoms (PONS) are recognized complications of regional anesthesia and orthopedic surgery. We aimed to better characterize prevalence and potential risk factors in a homogeneous population of randomized, controlled trial participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were pooled from two randomized controlled trials of analgesia after interscalene block with perineural or intravenous adjuvants (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02426736\">NCT02426736<\/jats:ext-link>,  <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03270033\">NCT03270033<\/jats:ext-link>). Participants were at least 18\u2009years of age and undergoing arthroscopic shoulder surgery at a single ambulatory surgical center. PONS were assessed by telephone follow-up at 14 days and 6\u2009months postoperatively, and defined as patient report of numbness, weakness, or tingling in the surgical limb, alone or in combination, and regardless of severity or etiology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At 14 days, PONS occurred in 83 of 477\u2009patients (17.4%). Among these 83\u2009patients, 10 (12.0%) continued to have symptoms a half-year after surgery. In exploratory univariate analyses, no patient, surgical or anesthetic characteristics were significantly associated with 14-day PONS except for lower postoperative day 1 Quality of Recovery-15 questionnaire total score (OR 0.97 (95% CI, 0.96 to 0.99), p&lt;0.01). This result was driven largely by the emotional domain question scores (OR 0.90 95%\u2009CI 0.85 to 0.96, p&lt;0.001). Report of all three of numbness, weakness and tingling at 14 days vs other 14-day symptom combinations was associated with persistent PONS at 6\u2009months (OR 11.5 95%\u2009CI 2.2 to 61.8, p&lt;0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>PONS are common after arthroscopic shoulder surgery performed with single injection ultrasound-guided interscalene blocks. No definitive mitigating risk factors were identified.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2022-104086","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T06:10:14Z","timestamp":1686291014000},"page":"553-560","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Postoperative neurological symptoms following arthroscopic shoulder surgery with interscalene block: an exploratory secondary analysis of pooled randomized controlled trial data"],"prefix":"10.1136","volume":"48","clinical-trial-number":[{"clinical-trial-number":"nct02426736","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03270033","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02426736","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03270033","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Samantha","family":"Frost","sequence":"first","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J J","family":"Amadeo","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faylene","family":"Funk","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Orthopedics, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Brown","sequence":"additional","affiliation":[{"name":"Orthopedics, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Orthopedics, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenden","family":"Dufault","sequence":"additional","affiliation":[{"name":"George and Fay Yee Centre for Health Care Innovation, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1614-7237","authenticated-orcid":false,"given":"Thomas Charles","family":"Mutter","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"2025101110223006000_48.11.553.1","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.1177\/0363546520971757","article-title":"Pain control after shoulder arthroscopy: a systematic review of randomized controlled trials with a network meta-analysis","volume":"49","author":"Hurley","year":"2021","journal-title":"Am J Sports Med"},{"key":"2025101110223006000_48.11.553.2","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1016\/j.arthro.2021.11.054","article-title":"Peripheral nerve blocks outperform general anesthesia for pain control in arthroscopic rotator cuff repair: a systematic review and meta-analysis","volume":"38","author":"Kalthoff","year":"2022","journal-title":"Arthroscopy"},{"key":"2025101110223006000_48.11.553.3","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1111\/anae.14796","article-title":"Prospect guideline for rotator cuff repair surgery: systematic review and procedure-specific postoperative pain management recommendations","volume":"74","author":"Toma","year":"2019","journal-title":"Anaesthesia"},{"key":"2025101110223006000_48.11.553.4","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1177\/0363546516667906","article-title":"Pain management after outpatient shoulder arthroscopy: a systematic review of randomized controlled trials","volume":"45","author":"Warrender","year":"2017","journal-title":"Am J Sports Med"},{"key":"2025101110223006000_48.11.553.5","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1213\/ANE.0000000000000688","article-title":"Will the real benefits of single-shot interscalene block please stand up? A systematic review and meta-analysis","volume":"120","author":"Abdallah","year":"2015","journal-title":"Anesth Analg"},{"key":"2025101110223006000_48.11.553.6","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000178"},{"key":"2025101110223006000_48.11.553.7","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000286"},{"key":"2025101110223006000_48.11.553.8","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1213\/ANE.0000000000001804","article-title":"Factors associated with risk of neurologic complications after peripheral nerve blocks: a systematic review","volume":"124","author":"Sondekoppam","year":"2017","journal-title":"Anesth Analg"},{"key":"2025101110223006000_48.11.553.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2009.05938.x"},{"key":"2025101110223006000_48.11.553.10","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101407"},{"key":"2025101110223006000_48.11.553.11","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181a3272c"},{"key":"2025101110223006000_48.11.553.12","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181ea5f5d"},{"key":"2025101110223006000_48.11.553.13","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31825cb3d6"},{"key":"2025101110223006000_48.11.553.14","doi-asserted-by":"crossref","first-page":"367","DOI":"10.5603\/AIT.2018.0049","article-title":"Regional anaesthesia induced peripheral nerve injury","volume":"50","author":"Pietraszek","year":"2018","journal-title":"Anaesthesiol Intensive Ther"},{"key":"2025101110223006000_48.11.553.15","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000125"},{"key":"2025101110223006000_48.11.553.16","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200110000-00015"},{"key":"2025101110223006000_48.11.553.17","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1007\/s12630-022-02229-w","article-title":"Postoperative neurologic symptoms in the operative arm after shoulder surgery with interscalene blockade: a systematic review","volume":"69","author":"Mutter","year":"2022","journal-title":"Can J Anaesth"},{"key":"2025101110223006000_48.11.553.18","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31825c258b"},{"key":"2025101110223006000_48.11.553.19","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181af61cb"},{"key":"2025101110223006000_48.11.553.20","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s12630-017-0989-7","article-title":"Effect of dexamethasone dose and route on the duration of interscalene brachial plexus block for outpatient arthroscopic shoulder surgery: a randomized controlled trial","volume":"65","author":"Holland","year":"2018","journal-title":"Can J Anaesth"},{"key":"2025101110223006000_48.11.553.21","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s12630-021-01942-2","article-title":"Analgesic duration of interscalene block after outpatient arthroscopic shoulder surgery with intravenous dexamethasone, intravenous dexmedetomidine, or their combination: a randomized-controlled trial","volume":"68","author":"Rodrigues","year":"2021","journal-title":"Can J Anaesth"},{"key":"2025101110223006000_48.11.553.22","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318289b84b"},{"key":"2025101110223006000_48.11.553.23","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001158"},{"key":"2025101110223006000_48.11.553.24","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e318228c835"},{"key":"2025101110223006000_48.11.553.25","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/ALN.0000000000000983","article-title":"Iv and perineural dexmedetomidine similarly prolong the duration of analgesia after interscalene brachial plexus block: a randomized, three-arm, triple-masked, placebo-controlled trial","volume":"124","author":"Abdallah","year":"2016","journal-title":"Anesthesiology"},{"key":"2025101110223006000_48.11.553.26","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000229705.45270.0f"},{"key":"2025101110223006000_48.11.553.27","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4234-9"},{"key":"2025101110223006000_48.11.553.28","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.013718"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2022-104086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:22:42Z","timestamp":1760203362000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2022-104086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,9]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,9,21]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/rapm-2022-104086"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2022-104086","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,9]]}}}