J Korean Orthop Assoc JKOA Journal of the Korean Orthopaedic Association 1226-2102 2005-8918 The Korean Orthopaedic Association 10.4055/jkoa.2011.46.4.288 Original Article Efficacy of Interscalene Block Anesthesia on the Early Postoperative Pain after Arthroscopic Shoulder Surgery: Comparison with General Anesthesia Kim Yong-Min M.D. Park Kyoung-Jin M.D. Kim Dong-Soo M.D. Choi Eui-Sung M.D. Shon Hyun-Chul M.D. Cho Byung-Ki M.D. Shin Young-Duck M.D. * Bae Seung-Hwan M.D. Department of Orthopedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. Correspondence to: Kyoung-Jin Park, M.D. Department of Orthopedic Surgery, College of Medicine, Chungbuk National University, 62, Gaesin-dong, Cheongju 361-711, Korea. TEL: +82-43-269-6077, FAX: +82-43-274-8719, oslion@chungbuk.ac.kr 08 2011 31 08 2011 46 4 288 293 12 06 2010 21 02 2011 Copyright © 2011 by The Korean Orthopaedic Association 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 Purpose

After shoulder arthroscopy via general anesthesia, most patients complain of severe pain during the early post operative period. In this study, the efficacy of pain control during the early post operative period with interscalene block anesthesia for shoulder arthroscopy was investigated and compared with general anesthesia.

 Materials and Methods

A prospective randomized controlled study was conducted on 40 patients who underwent shoulder arthroscopy between September 2008 and March 2009. The patients were grouped according to the method of anesthesia. The visual analogue scale (VAS) at the preoperative and early postoperative periods was checked and compared. In addition, the duration of patient controlled analgesia (PCA) usage and additional pain killer injections were examined.

 Results

There was no significant difference between the two groups for the VAS score before surgery, but the interscalene block group showed a significantly lower VAS score. The duration of PCA usage was also significantly longer for the interscalene block group, which implies less pain. The number of additional pain killer injections was significantly less in the interscalene block group.

 Conclusion

The patients who underwent shoulder arthroscopy with interscalene block had significantly less pain during the immediately post operative period for up to 48 hours. So patients could conduct initial rehabilitation and experience minimized side effects caused by analgesics due to the decreased use of pain killer. Therefore, interscalene block is considered a good method of anesthesia for the immediate postoperative pain control after shoulder arthroscopy.

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The photograph shows injection points of interscalene block. Level A, lateral approach; Level B, modified lateral approach; Level C, supraclavicular block. CC, cricoid cartilage; SCM, sternocleidomastoid muscle.

Gray arrow head shows needle insertion point, and white arrow head shows C5,6,7 nerve roots. SCM, sternocleidomastoid muscle; IJV, internal jugular vein; ASM, anterior scalene muscle; CA, carotid artery.

Interscalene block (IB) significantly lowered visual analogue scale (VAS) score during the immediate postoperative period and postoperative 48 hours compared to general anesthesia (GA).

PCA Usage and Additional Pain Killer Usage of Both Groups

PCA, patient controlled analgesia; IB, interscalene block; GA, general anesthesia.