Summary

Preoperative IBPB with general anesthesia for arthroscopic rotator cuff repair effectively reduced hemodynamic stability and significantly improved vision.

Abstract

Introduction

The interscalene brachial plexus block (IBPB) with general anesthesia before arthroscopic shoulder surgery would be more effective in establishing a clear visual field during surgery and shortening the duration of the surgical procedure than those of general anesthesia alone.

Materials And Methods

This study included 152 patients who had undergone arthroscopic rotator cuff repair. Group A received an IBPB before general anesthesia, and group B received general anesthesia alone. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR), and medications that were administered intra-operatively for hemodynamic stability were recorded. The surgical procedure was divided into four stages, and the duration of each stage was recorded. A visual clarity scale (VCS) was determined by arthroscopic visualization and technical ease.

Results

The VCS was significantly improved in group A at stage 2 (acromioplasty) and stage 3 (Greater tuberosity and tendon preparation) of the surgical procedures. There was no significant difference between the stage 1 (intra-articular soft tissue procedure, p=0.288) and stage 4 (tendon repair with suture bridge, p=0.062). SBP was elevated in Group B. (p<0.05) The administered analgesics were significantly higher in group B (p=0.003), but there were no differences in administered hypotensive agents (p=0.287). No significant difference was observed for the duration of the surgery (p=0.704).

Conclusions

Preoperative IBPB with general anesthesia for arthroscopic rotator cuff repair effectively reduced hemodynamic stability and significantly improved VCS throughout the arthroscopic surgery.