Comparison of interscalene brachial plexus block and intra-articular local anesthetic administration on postoperative pain management in arthroscopic shoulder surgery.
OBJECTIVE
In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine.


METHODS
In the first group of patients 20 mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB) were applied, while 20 mL 0.25% bupivacaine was given via intra-articular (IA) administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA) with morphine was used in all three groups for postoperative analgesia.


RESULTS
In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6h and the same was true for total morphine consumption in 24h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2h and lower than the control group in the 4th and 6th hours (p<0.05). In the IA group, VASr and VASm scores in the 2nd, 4th and 6th hours were lower than in the control group (p<0.05).


CONCLUSIONS
Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey. Electronic address: raksu@erciyes.edu.tr.
Recep
R
Aksu
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey.
Cihangir
C
Biçer
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey.
Ayşe
A
Ülgey
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey.
Adnan
A
Bayram
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey.
Işın
I
Güneş
Department of Orthopedic Surgery, Erciyes University, Medical Faculty, Kayseri, Turkey.
Ahmet
A
Güney
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey.
Mustafa Denizhan
MD
Yıldırım
Clinic of Anesthesiology and Reanimation, Department of Anesthesiology, Kayseri Training and Research Hospital, Kayseri, Turkey.
Günhan
G
Gökahmetoğlu
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey.
Karamehmet
K
Yıldız
D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001182:Arthroscopy / Q000379:methods*; D065527:Brachial Plexus Block / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D009020:Morphine; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D012785:Shoulder Joint / Q000601:surgery; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods
D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine
Anestésico local intra-articular; Arthroscopic shoulder surgery; Bloqueio do plexo braquial por via interescalênica guiado por ultrassom; Bupivacaine; Bupivacaína; Cirurgia artroscópica do ombro; Intra-articular local anesthetic; Ultrasound-guided interscalene brachial plexus block