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

  • Lars J. Lehmann
  • Gregor Loosen
  • Christel Weiss
  • Marc D. Schmittner
Original Article

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.

Keywords

Shoulder arthroscopy Regional anaesthesia Interscalene brachial plexus block Ultrasound General anaesthesia 

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Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  • Lars J. Lehmann
    • 3
  • Gregor Loosen
    • 1
  • Christel Weiss
    • 2
  • Marc D. Schmittner
    • 1
  1. 1.Department of Anaesthesiology and Surgical Intensive Care MedicineUniversity Medical Centre MannheimMannheimGermany
  2. 2.Department of Medical StatisticsUniversity Medical Centre MannheimMannheimGermany
  3. 3.Department of Orthopedic and Trauma Surgery, Orthopaedic and Trauma Surgery CentreUniversity Medical Centre MannheimMannheimGermany

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