Abstract
Background
Shoulder dislocations are a common presenting injury to the emergency department (ED),
with anterior dislocations comprising the majority of these cases. Some patients may
tolerate gentle manipulation and reduction, but many require analgesia of some type.
Oral or parenteral pain medication is often used alone or in combination with procedural
sedation if gentle manipulation fails to achieve reduction. Recently, this treatment
algorithm has grown to include regional anesthesia as a mode of analgesia for reduction
of shoulder dislocations in the form of brachial plexus blocks. It has been well described
that the interscalene and supraclavicular approach to the brachial plexus can be used
to assist in reduction of anterior shoulder dislocations; however, there has yet to
be any published literature regarding the use of ultrasound-guided retroclavicular
approach to the infraclavicular region (RAPTIR) brachial plexus blocks for shoulder
reduction.Case Report: We describe three patients who presented to the ED with anterior
shoulder dislocations. The RAPTIR block was performed, provided effective analgesia,
and facilitated successful shoulder reduction in all three patients.Why Should an
Emergency Physician Be Aware of This? The RAPTIR nerve block is a safe and effective
option for analgesia in the patient with an anterior shoulder dislocation. It may
have advantages over other brachial nerve blocks and avoids the risks and disadvantages
of procedural sedation and opioids.
Keywords
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Article info
Publication history
Published online: April 29, 2022
Accepted:
April 23,
2022
Received in revised form:
February 17,
2022
Received:
November 25,
2021
Footnotes
☆Submitted for poster presentation at the Annual Integrative Ultrasound Meeting Annual Meeting in San Diego, March 12–16, 2022.
Identification
Copyright
© 2022 Published by Elsevier Inc.
