Abstract:
Objective To explore efficiency of general anesthesia combined with interscalene brachial plexus block in the repair of giant rotator cuff under shoulder arthroscopy.
Methods Forty patients with repair of giant rotator cuff by shoulder arthroscopy were selected and randomly divided into experimental group and control group, with 20 cases in each group. The experimental group was treated with general anesthesia combined with interscalene brachial plexus block(15 mL of 0.4% ropivacaine),while general anesthesia was performed alone in the control group. The changes of blood pressure, heart rate, bispectral index(BIS)at time points of entry, skin cutting, intubation and extubation, and heart rate and mean arterial pressure at 45, 60, 75 and 90 min during operation were compared between two groups. The opioid consumption, recovery time, satisfaction degree, anxiety degree, times of pressing analgesia pump and VAS scores at 30 min, 6 h and 24 h after operation were compared between the two groups.
Results The heart rate and mean arterial pressure in the experimental group were significantly lower than those in the control group, and the BIS at the extubation was significantly higher than that in the control group(
P<0.05). The heart rate and mean arterial pressure at 45, 60, 75 and 90 min during operation in the experimental group were significantly lower than those in the control group(
P<0.05). In the experimental group, the times of pressing analgesia pump, the time to wake up and the consumption of remifentanil per unit time were significantly less than those in the control group, and the level of anxiety on the first day after operation was - significantly lower than that in the control group(
P<0.05). There was no significant difference in satisfaction degree between two groups(
P>0.05). The VAS score of experimental group at 30 minutes after operation was significantly lower than that of control group(
P<0.05).
Conclusion Application of general anesthesia combined with interscalene brachial plexus block in the repair of giant rotator cuff under shoulder arthroscopy can make the hemodynamics more stable during the perioperative period, make the operation field more clear, and reduce the dosage of general anesthetics, especially use of opioids. The patients have good postoperative analgesia effect.