Application of brachial plexus and suprascapular nerve block combined with general anesthesia in shoulder arthroscopy

Abstract

Objective To investigate the value and advantage of ultrasound guided intermuscular groove and suprascapular nerve block combined with general anesthesia in shoulder arthroscopy. Methods 40 American Society of Anesthesiologists (ASA)Ⅰ-Ⅱ patients undergoing elective arthroscopic shoulder surgery were randomly divided into two groups. Patients in group A were treated with general anesthesia, while patients in group B were treated with brachial plexus and suprascapular nerve block combined with general anesthesia. Mean arterial pressure (MAP), heart rate (HR) and visual analogy score ( VAS) were measured at preoperative (T0), 5 min after the beginning of the surgey (T1), 30 min after the beginning of the surgey (T2), at the end of the surgery (T3), and 30 min after removing laryngeal mask (T4). Bispectral index (BIS) was recorded at T1 and T2. The operation time, extubation time, dosage of opioids (sufentanyl), dosage of propofol, visual analogue scale (VAS) scores at awake time in post anesthesia care unit (PACU), and 6 h, 12 h, 24 h after surgery. Results There were no significant differences in the BIS between two groups at T1 and T2 (P>0.05). Both the MAP and HR had no statistical significance at T0 (P>0.05). MAP and HR in group B were significantly lower than those in group A from T1 to T4 (P<0.05). Compared with group A, patients in group B had significantly shorter extubation time (P<0.05), smaller dosages of sufentanyl and propofol (P<0.05), lower VAS scores at awake time 6 h and 12 h after surgery (P<0.05). Conclusions Brachial plexus and suprascapular nerve block combined with general anesthesia can offer better anesthesia status, reduce dosage of opioids and propofol, and can provide effective analgesia in shoulder arthroscopy. Key words: Brachial plexus block; Anesthesia, general; Ultrasonography; Arthroscopy; Shoulder joint