Interscalene plexus block versus general anaesthesia for shoulder surgery: a randomized controlled study

✍ Scribed by Lehmann, Lars J.; Loosen, Gregor; Weiss, Christel; Schmittner, Marc D.

• Book ID: 125349513
• Publisher: Springer
• Year: 2014
• Tongue: English
• Weight: 203 KB
• Volume: 25
• Category: Article
• ISSN: 1432-1068
• DOI: 10.1007/s00590-014-1483-3

✦ Synopsis

Objectives:

This randomized clinical trial evaluates interscalene brachial plexus block (isb), general anaesthesia (ga) and the combination of both anaesthetic methods (ga + isb) in patients undergoing shoulder arthroscopy.

Methods:

From july 2011 until may 2012, 120 patients (male/female), aged 20-80 years, were allocated randomly to receive isb (10 ml mepivacaine 1 % and 20 ml ropivacaine 0.375%), ga (propofol, sunfentanil, desflurane) or isb + ga. the primary outcome variable was opioid consumption at the day of surgery. anaesthesia times were analysed as secondary endpoints.

Results:

After surgery, 27 of 40 patients with a single isb bypassed the recovery room (p < 0.0001). postoperative monitoring time was significantly shorter with single isb compared with both other groups [ga: 93 (5-182) min vs. ga + isb: 57.5 (11-220) min vs. isb: 35 (5-106) min, p < 0.0001]. opioid consumption was reduced using a single isb at the day of surgery [ga: n = 25 vs. ga + isb: n = 10 vs. isb: n = 10, p = 0.0037].

Conclusion:

Isb is superior to ga and ga + isb in patients undergoing shoulder arthroscopy in terms of faster recovery and analgesics consumption.