Is there a place for interscalene block performed after induction of general anaesthesia?

Abstract

Background and objective: The timing of interscalene block in relation to general anaesthesia remains a controversial subject. We believe that the results of our study demonstrate that this block may be performed safely on anaesthetized patients, providing that certain conditions are met.

Methods: Five hundred and forty-eight cases of arthroscopic shoulder surgery were analysed retrospectively in order to identify the results of interscalene block performed after induction of general anaesthesia, but before the start of surgery. Patients were kept in hospital for 24 h and assessed before being discharged from the hospital and again in the period from 4 to 8 weeks after surgery. Duration of the block, quality of postoperative pain relief and neurological complications were recorded.

Results: Our study failed to reveal any permanent or long-term neurological complications attributable to interscalene block performed after induction of general anaesthesia.

Conclusion: It is our opinion that the primary factor for safe interscalene block is modification of the anaesthetic technique rather than the timing of regional block in relation to induction of general anaesthesia.