RESEARCH ARTICLE


Anesthesia for Shoulder Surgery: A Review of the Interscalene Block and a Discussion of Regional vs. General Anesthesia



Ahmed Ghaleb*, 1, Joshua D. Dilley2
1 Pain Medicine, Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR
2 Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR


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Creative Commons License
© 2012 Ghaleb and Dilley

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Pain Medicine, Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR; Tel: 501-686-8818; Fax: 501-526-4216; E-mails: aghalebmd@hotmail.com; ghalebahmed@uams.edu


Abstract

A review of the literature regarding anesthesia for shoulder surgery was performed. Current anesthetic tech-niques available include regional, general, or a combination of regional and general. We discuss each of these techniques, with an emphasis on regional (specifically interscalene block), in detail. Current evidence supports both regional and gen-eral anesthesia to be safe and efficient techniques. The interscalene block is considered by most to provide the best surgi-cal anesthesia and is the most commonly performed block for shoulder surgery. This paper aims to review the perform-ance of the interscalene block and to discuss alternative choices for shoulder surgery, namely general anesthesia and a combined general/regional technique. We also aim to provide considerations to aid in the performance of a safely admin-istered anesthetic.

Keywords: Acute pain management, Regional anesthesia, Shoulder surgery, continous penpheral nerve block, complication of interscalene block.