Combo of GA and interscalene brachial plexus block effective for shoulder surgery: Study
Research showed that ISB/GA resulted in significantly lower epinephrine, norepinephrine, and glucose levels perioperatively.
China: A recent study published in the journal BIO Integration, suggests the combined use of interscalene brachial plexus block with general anesthesia (ISB/GA) as a preferred anesthesia method for arthroscopic shoulder surgery.
In this article, Daowei Lin, and his team from Sun Yat-sen University, Guangdong, China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China and University of Virginia, Charlottesville, VA, USA discuss how interscalene brachial plexus block combined with general anesthesia attenuates stress and inflammatory response in arthroscopic shoulder surgery.
In arthroscopic shoulder surgery, general anesthesia (GA) is the common method of anesthesia. Recently, the combined usage of interscalene brachial plexus block with general anesthesia was reported to have a lower incidence of adverse side effects than GA alone. However, to date, no study has compared stress and inflammatory responses between these two methods. Since stress and inflammatory responses are critical on intraoperative management and postoperative recovery, the authors of this study integrated the laboratory and clinical methods and compared the stress and inflammatory factors, such as epinephrine, norepinephrine, glucose, lactate, inflammatory factors tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), as well as the clinical outcomes to determine whether ISB/GA provides an advantage on stress and inflammatory inhibition.
Data showed that ISB/GA resulted in significantly lower epinephrine, norepinephrine, and glucose levels perioperatively. Six hours after the operation, the TNF-α and IL-6 levels were also significantly lower in the ISB/GA group. ISB/GA patients had lower blood pressure, a more stable heart rate, lower visual analog scale score, and less opioid consumption during and after surgery. The results indicate that ISB/GA is a better choice for arthroscopic shoulder surgery, owing to less stress and inflammatory responses during and after operation, which provides better clinical outcomes.
The study titled, "Combination of Interscalene Brachial Plexus Block with General Anesthesia Attenuates Stress and Inflammatory Response in Arthroscopic Shoulder Surgery," is published in the journal Bio Integration.