title: Combining interscalene brachial plexus block with intravenous-inhalation combined anesthesia for upper extremity fractures surgery: a randomized controlled trial.
abstract: BACKGROUND
  A parallel-group randomized controlled trial (RCT) was conducted to evaluate the effect of combining the interscalene brachial plexus block (IBPB) with Intravenous-inhalation combined anesthesia to isolated Intravenous-inhalation anesthesia in the upper extremity fractures surgery of elderly patients.
  
  
  METHODS
  One hundred elderly patients who underwent upper extremity surgery were randomly assigned to received isolated Intravenous-inhalation combined anesthesia (group CI, n = 50) and IBPB associated with Intravenous-inhalation combined anesthesia (group NB, n = 50). Associated side effects, recovery time after operation, as well as the dose of intraoperative vasoactive agents and auxiliary drugs were noted.
  
  
  RESULTS
  The two groups were not significantly different in gender (P = 0.539), ages (P = 0.683) and weight (P = 0.212). Five patients (10%) in the group NB and 17 patients (34%) in the group CI suffered from preoperative hypotension (P = 0.004). Besides, lower incidence of other adverse effects such as mental stress, incision pain and hypertension were also found in the group NB; however, the differences were not statistically significant (P > 0.05). The consumption of general anesthetics in the group NB was significantly less than that of the group CI (propofol, P = 0.004; lsoflurane, P < 0.001), and the recovery time of the group NB was significantly shorter than that of the group CI (P = 0.020).
  
  
  CONCLUSIONS
  Combining IBPB with Intravenous-inhalation combined anesthesia in elderly patients hold a greater potential for upper extremity fractures surgery due to its improved clinical effectiveness and fewer side effects.
authors.affiliation: Department of Anesthesiology, ShuGuang Hospital affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201203, PR China.
authors.forename: Lan
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Department of Anesthesiology, ShuGuang Hospital affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201203, PR China. Electronic address: tangwei241@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Tang
authors.affiliation: Department of Anesthesiology, ShuGuang Hospital affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201203, PR China.
authors.forename: Guo-qiang
authors.initials: GQ
authors.lastname: Fu
authors.affiliation: Department of Anesthesiology, ShuGuang Hospital affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201203, PR China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, ShuGuang Hospital affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201203, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, ShuGuang Hospital affiliated to Shanghai Traditional Chinese Medicine University, Shanghai 201203, PR China.
authors.forename: Wen-ting
authors.initials: WT
authors.lastname: Chen
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000706:statistics & numerical data; D000769:Anesthesia, Inhalation / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D000772:Anesthesia, Local / Q000706:statistics & numerical data; D019162:Anesthetics, Combined / Q000008:administration & dosage; D018681:Anesthetics, General / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D065527:Brachial Plexus Block / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D013997:Time Factors; D034941:Upper Extremity / Q000293:injuries*
chemical_list: D019162:Anesthetics, Combined; D018681:Anesthetics, General; D018686:Anesthetics, Intravenous
keywords: Inhalational anesthetics; Interscalene brachial plexus block; Intravenous anesthesia; Side effect