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

Abstract

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