Interscalene block alone vs interscalene block with erector spinae plane block for shoulder arthroscopy anesthesia: a randomized-controlled trial

Abstract. Introduction:. Shoulder arthroscopy (SA) is usually related to postoperative pain. This work aimed to compare the effectiveness of interscalene block (ISB) alone vs ISB and erector spinae plane block (ESPB) together applied in SA. Methods:. This controlled, randomized study trial included 50 patients, with an age range of 18 to 65 years, both sexes, admitted for elective SA. Patients were equally randomized to Group IE: received ISB using 10-mL bupivacaine 0.5% plus ESPB at T2 using 10-mL bupivacaine 0.5%. Group I: received ISB using 15-mL bupivacaine 0.5%. The blocks were performed by ultrasound guidance. During the surgery, 1 µg/kg intravenous increments of fentanyl were administered if the patient complained of pain. Results:. There was a significant lowering in the intraoperative fentanyl consumption in group IE compared with group I (median [interquartile range]: 0 [0–0] vs 60 [0–75] µg, P < 0.05). Numeric rating scale measurements, first time to rescue, and meperidine consumption in the first 24-hour postoperative were insignificantly different between the groups. Satisfaction in group IE was significantly higher than in group I (P = 0.001). The incidence of Horner syndrome was insignificantly different between the groups, whereas hemidiaphragmatic paralysis (HDP) in group IE appeared considerably lower than that in group I (P < 0.001). Conclusions:. Combining ESPB with ISB during shoulder arthroscopy (SA) provided a more effective analgesic result by decreasing the intraoperative required consumption of fentanyl with higher patient satisfaction with lower HDP. Interscalene block alone was comparable to ESPB and ISB regarding postoperative pain.

Abstract licence: CC BY-NC-ND

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