{
  "abstract": "Background and Aims Shoulder arthroscopy increasingly uses exclusive regional anaesthesia (RA). While interscalene plus supraclavicular nerve blocks (ISB + SCNB) reliably numb most tissues, the posterior-portal ‘Soft Point’ may remain sensitive, risking pain and conversion to general anaesthesia (GA). The primary aim of the CAESAR study is to map the anaesthetised area and quantify the incidence of Soft Points that escape regional anaesthesia (RA).Methods Ninety-seven adults scheduled for outpatient shoulder arthroscopy received ultrasound-guided ISB followed by SCNB. After 30 min, dermatomes and the surgeon-marked Soft Point were tested with ice (0 = no sensation; 1 = pain). A painful Soft Point was infiltrated with 3 mL 0.35% ropivacaine. Primary outcome: proportion of sensitive Soft Points. Secondary outcomes: incision pain (VAS > 3/10), GA conversion, propofol use, time to active mobilisation, and pain/analgesia through day 7Results The Soft Point remained sensitive in 10/97 patients (10.3%); all were infiltrated. Two GA conversions (2.1%) occurred (anxiety, surgical difficulty). Mean propofol dose was 75 ± 28 mg; surgery lasted 65 ± 13 min. Analgesia lasted 28 ± 5 h, permitting active mobilisation after 29 ± 6 h. On day 1, 92% of patients recorded Numeric Rating Scale < 3.Conclusions Roughly one patient in ten has a Soft Point not covered by ISB + SCNB, yet intra-operative discomfort and GA conversion are rare. Systematic Soft Point infiltration is therefore unwarranted; simple pre-operative testing can identify the minority who benefit. Our findings corroborate those of Chavez-Gama et al., who reported 12% cold-negative areas after regional anaesthesia without significant clinical impact. Exclusive RA provides excellent, opioid-sparing analgesia for day-case shoulder arthroscopy, corroborating previous mapping studies.Abstract EP050 Figure 1Map of the anaesthesied area (Interscalene block + cervical block)Abstract EP050 Table 1Results",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology, Quincy Anesthesie, Quincy Sous Senart, France"
      ],
      "name": "Yoann Elmaleh"
    },
    {
      "affiliations": [
        "Anesthesiology, Quincy Anesthesie, Quincy Sous Senart, France"
      ],
      "name": "Thierry Garnier"
    }
  ],
  "title": "EP050 Caesar study: interest of the ‘soft point’ during shoulder arthroscopy under exclusive regional anaesthesia",
  "uid": "81fb9eb3-5f25-5f32-b018-91d4adaed81f"
}