title: The Patterns of Utilization of Interscalene Nerve Blocks for Total Shoulder Arthroplasty.
abstract: The interscalene block (ISB) is a common adjunct to general anesthesia for total shoulder arthroplasty (TSA). The aim of the study was to report the current national demographics of the patients who are receiving ISB for TSAs. We performed a retrospective analysis of data from the National Anesthesia Clinical Outcomes Registry from 2010 to 2015. Of 28,810 cases, 42.1% received an ISB. Only 0.83% of cases received regional anesthesia as the primary anesthetic. From 2010 to 2014, there has been an increase in ISB utilization for this surgery (odds ratio, 1.21; 95% confidence interval, 1.19-1.23; P < .0001). Furthermore, we report a geographic distribution of block utilization in the United States. We have identified national patterns for the utilization of regional anesthesia for TSAs that may provide insight into future design of research studies.
authors.affiliation: From the *Department of Anesthesiology, University of California, San Diego, California; †Department of Anesthesiology and Pain Management, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois; ‡Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana; §US Anesthesia Partners, Fort Lauderdale, Florida; and ‖Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Gabriel
authors.forename: Alexander
authors.initials: A
authors.lastname: Nagrebetsky
authors.forename: Alan D
authors.initials: AD
authors.lastname: Kaye
authors.forename: Richard P
authors.initials: RP
authors.lastname: Dutton
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder / Q000009:adverse effects / Q000379:methods*; D001340:Autonomic Nerve Block / Q000379:methods / Q000706:statistics & numerical data*; D001917:Brachial Plexus / Q000187:drug effects / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult