[Interscalene block for total shoulder arthroplasty: comparative study (ultrasound vs. neurostimulation)]

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Musculoskeletal Surgery

Background:

• Ultrasonography is increasingly used in anesthesiology, often replacing neurostimulation for peripheral nerve localization.
• Interscalene nerve blocks are crucial for managing pain during total shoulder arthroplasty.

Purpose of the Study:

• To compare the effectiveness of ultrasound-guided versus neurostimulation-guided interscalene nerve blocks for total shoulder arthroplasty.
• To evaluate key outcomes including block latency, efficacy, patient satisfaction, and complication rates.

Main Methods:

• A prospective, non-randomized comparative study involving 110 patients undergoing total shoulder arthroplasty.
• Patients received either a neurostimulation-guided or ultrasound-guided interscalene nerve block.
• Outcomes measured included block latency, sensory and motor block, success rate, postoperative pain, patient satisfaction, and complications.

Main Results:

• Both techniques demonstrated a 100% success rate with comparable block latency and postoperative pain scores.
• Ultrasound guidance resulted in a significantly lower complication rate (3.6%) compared to neurostimulation (18.18%).
• Patient satisfaction was high in both groups, with a slight trend favoring ultrasound.

Conclusions:

• Ultrasound-guided interscalene nerve block is the preferred technique for elective total shoulder arthroplasty due to its improved safety profile.
• The study supports the integration of ultrasound technology for enhanced regional anesthesia procedures.