title: Supplemental Interscalene Blockade to General Anesthesia for Shoulder Arthroscopy: Effects on Fast Track Capability, Analgesic Quality, and Lung Function.
abstract: BACKGROUND
  After shoulder surgery performed in patients with interscalene nerve block (without general anesthesia), fast track capability and postoperative pain management in the PACU are improved compared with general anesthesia alone. However, it is not known if these evidence-based benefits still exist when the interscalene block is combined with general anesthesia.
  
  
  METHODS
  We retrospectively analyzed a prospective cohort data set of 159 patients undergoing shoulder arthroscopy with general anesthesia alone (n = 60) or combined with an interscalene nerve block catheter (n = 99) for fast track capability time. Moreover, comparisons were made for VAS scores, analgesic consumption in the PACU, pain management, and lung function measurements.
  
  
  RESULTS
  The groups did not differ in mean time to fast track capability (22 versus 22 min). Opioid consumption in PACU was significantly less in the interscalene group, who had significantly better VAS scores during PACU stay. Patients receiving interscalene blockade had a significantly impaired lung function postoperatively, although this did not affect postoperative recovery and had no impact on PACU times.
  
  
  CONCLUSIONS
  The addition of interscalene block to general anesthesia for shoulder arthroscopy did not enhance fast track capability. Pain management and VAS scores were improved in the interscalene nerve block group.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital Marburg, 35033 Marburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Zoremba
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital Marburg, 35033 Marburg, Germany ; Department of Anesthesia and Intensive Care Medicine, Clinique Bénigne Joly, 21240 Talant, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kratz
authors.affiliation: Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Dette
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital Marburg, 35033 Marburg, Germany.
authors.forename: Hinnerk
authors.initials: H
authors.lastname: Wulf
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital Marburg, 35033 Marburg, Germany.
authors.forename: Thorsten
authors.identifier: 0000-0002-0135-4826
authors.initials: T
authors.lastname: Steinfeldt
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital Marburg, 35033 Marburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiesmann
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D000768:Anesthesia, General; D001182:Arthroscopy / Q000009:adverse effects; D001917:Brachial Plexus / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy / Q000473:pathology; D012782:Shoulder / Q000294:innervation / Q000473:pathology / Q000601:surgery*
chemical_list: D000700:Analgesics