Feasibility and Adoption of Low-Volume Ultrasound-Guided Superior Trunk Block for Shoulder Reduction in the Emergency Department
Abstract
Background: Procedural sedation and analgesia (PSA) is commonly used for shoulder dislocation reduction in emergency departments (EDs), but it requires monitoring resources and may be associated with sedation-related adverse events. Ultrasound-guided regional anesthesia (UGRA), particularly low-volume superior trunk (ST) block, has emerged as a potential alternative. However, little is known about how this technically demanding technique can be implemented and adopted in routine ED practice. This study aimed to describe the implementation and clinical adoption of low-volume ultrasound-guided ST block for shoulder reduction in a specialized ED over a six-year period. Methods: This retrospective single-center observational cohort study included all consecutive patients undergoing shoulder reduction in a specialized orthopedic ED between February 2018 and February 2024. Patients were managed according to routine clinical practice using either UGRA or PSA, with treatment choice determined by the treating physician. The primary objective was to describe the implementation and clinical adoption of low-volume ST block in routine practice. Additional analyses assessed temporal trends in technique utilization, local anesthetic volume, provider distribution, and ED length of stay. Results: A total of 206 patients were included (124 UGRA; 82 PSA). The use of UGRA increased progressively during the study period, whereas PSA decreased accordingly (p p Conclusions: This retrospective…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 206 participants or records.
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