Lars J Lehmann1, Gregor Loosen, Christel Weiss, Marc D Schmittner. 1. Department of Orthopedic and Trauma Surgery, Orthopaedic and Trauma Surgery Centre, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68187, Mannheim, Germany, dr.lehmann@me.com.
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.
RCT Entities:
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.
Authors: Ikemefuna Onyekwelu; Omar Khatib; Joseph D Zuckerman; Andrew S Rokito; Young W Kwon Journal: J Shoulder Elbow Surg Date: 2012-06 Impact factor: 3.019
Authors: Nicholas A Trasolini; Ioanna K Bolia; Hyunwoo P Kang; Anthony Essilfie; Erik N Mayer; Reza Omid; Seth C Gamradt; George F Hatch; Alexander E Weber Journal: Orthop J Sports Med Date: 2020-06-23