J Korean Orthop Assoc.  2011 Aug;46(4):288-293. 10.4055/jkoa.2011.46.4.288.

Efficacy of Interscalene Block Anesthesia on the Early Postoperative Pain after Arthroscopic Shoulder Surgery: Comparison with General Anesthesia

• Kim YM
• Park KJ
• Kim DS
• Choi ES
• Shon HC
• Cho BK
• Shin YD
• Bae SH

• KMID: 2185426
• DOI: http://doi.org/10.4055/jkoa.2011.46.4.288

Abstract

PURPOSE
After shoulder arthroscopy via general anesthesia, most patients complain of severe pain during the early post operative period. In this study, the efficacy of pain control during the early post operative period with interscalene block anesthesia for shoulder arthroscopy was investigated and compared with general anesthesia.
MATERIALS AND METHODS
A prospective randomized controlled study was conducted on 40 patients who underwent shoulder arthroscopy between September 2008 and March 2009. The patients were grouped according to the method of anesthesia. The visual analogue scale (VAS) at the preoperative and early postoperative periods was checked and compared. In addition, the duration of patient controlled analgesia (PCA) usage and additional pain killer injections were examined.
RESULTS
There was no significant difference between the two groups for the VAS score before surgery, but the interscalene block group showed a significantly lower VAS score. The duration of PCA usage was also significantly longer for the interscalene block group, which implies less pain. The number of additional pain killer injections was significantly less in the interscalene block group.
CONCLUSION
The patients who underwent shoulder arthroscopy with interscalene block had significantly less pain during the immediately post operative period for up to 48 hours. So patients could conduct initial rehabilitation and experience minimized side effects caused by analgesics due to the decreased use of pain killer. Therefore, interscalene block is considered a good method of anesthesia for the immediate postoperative pain control after shoulder arthroscopy.

Keyword

shoulder arthroscopy; interscalene block; general anesthesia; pain control

MeSH Terms

Analgesia, Patient-Controlled
Analgesics
Anesthesia
Anesthesia, General
Arthroscopy
Humans
Pain, Postoperative
Passive Cutaneous Anaphylaxis
Postoperative Period
Prospective Studies
Shoulder
Analgesics

Figure

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  Figure 1 The photograph shows injection points of interscalene block. Level A, lateral approach; Level B, modified lateral approach; Level C, supraclavicular block. CC, cricoid cartilage; SCM, sternocleidomastoid muscle.

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  Figure 2 Gray arrow head shows needle insertion point, and white arrow head shows C5,6,7 nerve roots. SCM, sternocleidomastoid muscle; IJV, internal jugular vein; ASM, anterior scalene muscle; CA, carotid artery.

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  Figure 3 Interscalene block (IB) significantly lowered visual analogue scale (VAS) score during the immediate postoperative period and postoperative 48 hours compared to general anesthesia (GA).

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