Comparative study between the effect of ultrasound Guided interscalene block versus patient-controlled intravenous analgesia on postoperative analgesia after shoulder surgery

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Department of Anesthesia and Intensive Care, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt.

Abstract

Background: The gold standard for evaluating the efficacy of acute postoperative pain treatment is PCA. PCIVA is used more often in conjunction with opioids, however potent opioids might have undesirable side effects, such as nausea and pruritus. Brachial plexus block has important advantages for upper extremity surgery over general anaesthesia. With the ISB, any surgery on the upper extremities is possible. In contrast to single-shot ISB with a long-acting local anaesthetic, parenteral opioids are less effective, but the effect is only temporary. Parenteral opioids or single-shot ISB are less effective at relieving pain than continuous ISB. Aim: to contrast intravenous analgesia managed by the patient with an interscalene block guided by ultrasonography for postoperative pain relief following shouler surgery. Subject and Methods: In Cairo's Al-Azhar University Hospitals, this study involved 60 patients divided into two groups. Results: The group ISB required less amount of total narcotic consumption in the first 24h. There is significant difference between the groups regarding studied adverse effects especially narcotic related side effects which are higher in PCA group. Conclusion: Ultrasound Guided interscalene is more effective than patient-controlled intravenous analgesia after shoulder surgery in controlling pain, HR and blood pressure. However, there is no significant difference between the groups regarding time to rescue analgesia, side effects and patient satisfaction

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