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


CONCLUSIONS
ISB is superior to GA and GA + ISB in patients undergoing shoulder arthroscopy in terms of faster recovery and analgesics consumption.
Department of Orthopedic and Trauma Surgery, Orthopaedic and Trauma Surgery Centre, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68187, Mannheim, Germany, dr.lehmann@me.com.
Lars J
LJ
Lehmann
Gregor
G
Loosen
Christel
C
Weiss
Marc D
MD
Schmittner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D001182:Arthroscopy; D065527:Brachial Plexus Block / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D017060:Patient Satisfaction; D012785:Shoulder Joint / Q000601:surgery*; D013997:Time Factors; D055815:Young Adult
D000701:Analgesics, Opioid