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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Interscalene block versus upper trunk block in shoulder arthroscopy: Randomized comparative study of the ease between
A M M Ahmed1, M A Moustafa1, A S Alabd1
1Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Revista Espanola De Anestesiologia Y Reanimacion
|March 23, 2026
Summary
Upper trunk block (UTB) offers comparable pain relief to interscalene brachial plexus block (ISB) for shoulder surgery. UTB is technically easier and safer, with less impact on diaphragmatic function, making it a viable alternative for anesthesia trainees.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Surgical Procedures
Background:
- Interscalene brachial plexus block (ISB) is the standard for shoulder arthroscopic surgery but has complications.
- Anatomical variations and technical challenges exist with ISB.
- Upper trunk block (UTB) presents a potential alternative.
Purpose of the Study:
- To compare the success rate and safety of UTB versus ISB.
- To evaluate secondary outcomes including block performance time, pain, and diaphragmatic function.
Main Methods:
- A randomized controlled trial involving 120 patients undergoing shoulder arthroscopic surgery.
- Patients were assigned to either ISB (n=60) or UTB (n=60) before general anesthesia.
- Blocks were performed by anesthesia trainees under supervision.
Main Results:
- No significant difference in success rate, worst pain scores, or opioid consumption between UTB and ISB.
- UTB performance was faster and required fewer guidance interventions.
- ISB significantly impacted diaphragmatic function more than UTB.
Conclusions:
- UTB provides equivalent analgesia to ISB for shoulder arthroscopy.
- UTB is a safer and technically simpler alternative for anesthesia trainees.
- Reduced diaphragmatic compromise makes UTB a favorable option.
