[Effects of continuous interscalene brachial plexus block plus general anesthesia versus general anesthesia alone on perioperative management of arthroscopic rotator cuff repair surgery]

Abstract

Objective: To compare continuous interscalene brachial plexus block (CISB) in the patients undergoing rotator cuff repair surgery.

Methods: A total of 60 patients undergoing rotator cuff repair surgery were randomly assigned to either ISB plus GA group (ISB + GA group) or GA group. Preoperatively, an interscalene catheter was placed in the ISB + GA group patients. Both groups received general anesthesia. The intraoperative mean arterial pressure (MAP) at the level of external acoustic meatus was maintained at a target of 60 - 65 mm Hg with a continuous infusion of remifentanil. Postoperatively, the patients in the ISB + GA and GA groups received CISB and patient controlled intravenous analgesia (PCIA) respectively for 48 h.

Results: Surgical field conditions were similar in two groups (P = 1.000). Compared to the GA group, the consumption of remifentanil [(0.04 ± 0.03) vs (0.14 ± 0.03) µg×kg(-1)×min(-1), P < 0.01] and the inhalational concentration of sevoflurane(1.80% ± 0.5% vs 2.1% ± 0.5%, P < 0.05)were lower in the ISB + GA group. Compared to the GA group, the values of MAP and heart rate (HR) were lower at all postoperative time-points in the ISB + GA group(P < 0.05). The postoperative measurements of numerical rating pain score (NRPS) were lower (P < 0.01) and the level of patient satisfaction was greater in the ISB + GA group [8(6 - 10) vs 7 (5 - 10), P < 0.01].

Conclusion: In comparisons with GA alone for rotator cuff repair surgery, the combined uses of ISB and GA may achieve a better perioperative control of hemodynamic responses, a markedly reduced consumption of general anesthetics, a rapid recovery of consciousness from anesthesia, superior analgesia with fewer side effects and greater patient satisfaction.