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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 September;67(9):613-9

language: English

Reduction of operating and recovery room times and overnight hospital stays with interscalene blocks as sole anesthetic technique for rotator cuff surgery

Chelly J. E., Greger J. *, Al Samsam T. **, Gebhard R. *, Masson M. ***, Matuszczak M. *, Sciard D. *

From the Region­al Anes­the­sia, *Anes­the­sio­lo­gy
**Region­al Anes­the­sia Fel­low Depart­ment of Anes­the­sio­lo­gy The Uni­ver­sity of Tex­as-Hous­ton Health Sci­ence Cen­ter, Hous­ton, Tex­as
***Direc­tor, ­Park Pla­za ­Hand and Upper Extrem­ity Cen­ter Park Pla­za Hos­pi­tal, Hous­ton, Tex­as


Back­ground. The ­effort to ­decrease hos­pi­tal ­stays and to ­increase oper­at­ing ­room effi­ca­cy has ­become an impor­tant con­sid­er­a­tion in the prac­tice of anes­the­sia.
Meth­ods. Fif­ty-­three ­patients who under­went shoul­der rota­tor ­cuff ­repair in the sit­ting posi­tion ­were divid­ed ­into ­four ­groups accord­ing to the anes­the­sia tech­nique ­used: ­Group 1 (gen­er­al anes­the­sia), ­Group 2 (inter­sca­lene ­block), ­Group 3 (inter­sca­lene com­bined ­with gen­er­al anes­the­sia) and ­Group 4 (gen­er­al anes­the­sia com­bined ­with ­local injec­tion of ­local anes­thet­ics). Inter­sca­lene ­blocks ­were per­formed pre­op­er­a­tive­ly, ­using a ­nerve stim­u­la­tor. ­After appro­pri­ate­ly locat­ing the bra­chi­al plex­us, a mix­ture of 40 ml of 2% lid­o­caine and 0.5% bupiv­a­caine (v/v) was inject­ed.
­Results. As com­pared to gen­er­al anes­the­sia, the use of an inter­sca­lene ­block ­alone ­reduced the fol­low­ing oper­at­ing ­room ­times: 1) ­from the ­patient’s arri­val in the oper­at­ing ­room to the begin­ning of sur­gery and 2) ­from the end of sur­gery to the ­patient’s depar­ture ­from the oper­at­ing ­room. Use of the inter­sca­lene ­block ­also result­ed in a reduc­tion of recov­ery ­time ­when com­pared to ­Groups 1, 3 and 4 by 40, 56 and 66%, respec­tive­ly. Com­pared to ­Group 1, ­this anes­the­sia tech­nique was fur­ther­more asso­ciat­ed ­with a 64% ­decrease in the num­ber of ­patients hos­pi­tal­ized over­night.
Con­clu­sions. ­This ­study con­firms ­that the inter­sca­lene ­block as ­sole anes­the­sia tech­nique is ­safe and effec­tive and can con­trib­ute to short­en the hos­pi­tal ­length of ­stay of ­patients under­go­ing shoul­der rota­tor ­cuff sur­gery.

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