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

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objectives

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].

Conclusion

ISB is superior to GA and GA + ISB in patients undergoing shoulder arthroscopy in terms of faster recovery and analgesics consumption.

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Acknowledgments

The study was funded by the University Medical Centre Mannheim.

Conflict of interest

None of the authors declares a conflict of interest.

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Authors and Affiliations

  1. Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68187, Mannheim, Germany

    Gregor Loosen & Marc D. Schmittner

  2. Department of Medical Statistics, University Medical Centre Mannheim, Ludolf- Krehl-Str. 13-17, 68167, Mannheim, Germany

    Christel Weiss

  3. Department of Orthopedic and Trauma Surgery, Orthopaedic and Trauma Surgery Centre, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68187, Mannheim, Germany

    Lars J. Lehmann

Authors
  1. Lars J. Lehmann
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  2. Gregor Loosen
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  3. Christel Weiss
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  4. Marc D. Schmittner
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Correspondence to Lars J. Lehmann.

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Lehmann, L.J., Loosen, G., Weiss, C. et al. Interscalene plexus block versus general anaesthesia for shoulder surgery: a randomized controlled study. Eur J Orthop Surg Traumatol 25, 255–261 (2015). https://doi.org/10.1007/s00590-014-1483-3

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  • DOI: https://doi.org/10.1007/s00590-014-1483-3

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