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Comparison of Ultrasound-Guided Supraclavicular and Interscalene Brachial Plexus Blocks in Postoperative Pain Management After Arthroscopic Shoulder Surgery.

Comparison of Ultrasound-Guided Supraclavicular and Interscalene Brachial Plexus Blocks in Postoperative Pain Management After Arthroscopic Shoulder Surgery.

Pain Pract. 2018 Sep 30;:

Authors: Karaman T, Karaman S, Aşçı M, Tapar H, Şahin A, Dogru S, Suren M

Abstract
BACKGROUND: The interscalene brachial plexus block (ISBB) is an effective procedure for minimizing postoperative opioid consumption and pain following arthroscopic shoulder surgery (ASS). The ultrasound (US)-guided supraclavicular brachial plexus block (SCBB) seems to be an alternative technique for ASS. However, evidence is lacking regarding the impact of SCBB on postoperative pain management and recovery after ASS. The aim of this study was to compare the effects of SCBB with ISBB in terms of postoperative pain and quality of recovery after ASS.
METHODS: A total of 62 adult patients scheduled for ASS under general anesthesia were randomized into 2 groups to receive either ISBB (IB group, n = 31) or SCBB (SB group, n = 29) with 20 ml of 0.25% bupivacaine under US guidance. Assessments included postoperative pain scores, additional analgesic requirement, timing of the first analgesic requirement, quality of recovery-40 (QoR-40) scores, block characteristics, and side effects.
RESULTS: No significant differences were found between the two groups for pain scores (p=0.34), timing of first analgesic requirement (p=0.30), additional analgesic requirement (p=0.34), or QoR-40 (p=0.13) scores. The block characteristics regarding procedure time (p=0.95), block failure, and onset time of sensory blockade (p=0.33) were similar. Horner’s syndrome occurred in 8 patients in the IB group and 1 patient in the SB group (p=0.015).
CONCLUSIONS: This study showed that US-guided SCBB is as effective as ISBB in reducing postoperative pain and improving the quality of recovery for ASS. This article is protected by copyright. All rights reserved.

PMID: 30269430 [PubMed – as supplied by publisher]

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