Intraoperative effect of Interscalene brachial plexus block to Arthroscopic Rotator cuff repair surgery

Abstract

Purpose : To determine whether the placement of an interscalene brachial plexus block (IBPB) with general anesthesia before arthroscopic rotator cuff repair surgery would be effective in establishing a clear visual field during surgery and shortening the duration of the procedure. Methods : This study included 152 patients who had undergone arthroscopic rotator cuff repair. Group A received an IBPB before general anesthesia, and group B did not receive the IBPB. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) 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. VCS and the medication that was administered intra-operatively for hemodynamic stability were recorded. 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 (P<0.05). 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 and DBP were elevated, and HR was increased significantly in group B at all stages (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 was beneficial in maintaining hemodynamic stability and improving the VCS during surgery.