Interscalene Block for Pain Relief After Shoulder Surgery

Postoperative Pain and Other Acute Pain Syndromes

“…A single-injection ISB provides analgesia superior to that of systemic opioids. A reduction in verbal pain scale scores of greater than 50% [205][206][207] and a reduction in total opioid requirement [205][206][207][208] have been reported. CISB for shoulder surgery provides better analgesia than placebo or systemic opioids do and is associated with less opioid consumption and fewer opioid-related side effects.…”

Postoperative Pain and Other Acute Pain Syndromes

“…The superior pain relief by this technique is well documented when compared with opioid analgesia. Greater than 50% reduction in the verbal pain scale (VPS) scores, [135][136][137] delayed time to fi rst analgesic use, 136 and reduced total opioid requirement [135][136][137][138] have been reported. Interscalene blocks can be performed either as a single injection block for postoperative pain relief, typically lasting between 12 to 20 hours, or as a continuous catheter insertion with a continuous infusion of local anesthetic leading to more consistent and prolonged analgesia.…”

(iii) Anaesthesia for shoulder surgery

“…10 Moreover operating room efficiency is better with regional anaesthesia as compared to general anaesthesia. 11 These benefits, coupled with the safety and efficacy of the block, would suggest that interscalene block in experienced hands is the anaesthetic technique of choice for most shoulder surgical procedures.…”

“…The interscalene approach to the brachial plexus is best suited to surgery of the shoulder 10,12,13 where a block of the lower cervical plexus is also desirable. The use of a nerve stimulator or elicitation of paraesthesiae, is used to place the local anaesthetic solution accurately.…”