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

European Journal of Orthopaedic Surgery & Traumatology volume 25, pages 255–261 (2015)Cite this 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.

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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.

Author information

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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Corresponding author

Correspondence to Lars J. Lehmann.

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Cite this article

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

Keywords

  • Shoulder arthroscopy
  • Regional anaesthesia
  • Interscalene brachial plexus block
  • Ultrasound
  • General anaesthesia