Abstract
A COMPARATIVE STUDY OF EFFICACY OF ONLY GA VIS A VIS COMBINATION OF INTERSCALENE BRACHIAL PLEXUS BLOCK AND GA FOR ACHIEVING HYPOTENSIVE ANAESTHESIA ALONGWITH POSTOPERATIVE PAIN RELIEF IN SHOULDER ARTHROSCOPY

Dr. R. K. Singh and Dr. Manish Gupta

ABSTRACT

Background: Shoulder arthroscopies require bloodless field for visualization hence the need for hypotensive anaesthesia. Aim: In this study we have administrated Interscalene Brachial Plexus block prior to GA to achieve hypotension with added advantage of satisfactory postop pain relief and did a comparative study. Methods: A prospective comparative study was done between the two groups (Gp G consisted only GA and Gp GIS consisted Interscalene Brachial Plexus Nerve block followed by GA), in a zonal government hospital.45 pts were studied in Gp G and 46 in Gp GIS. In the ISBN a fixed solution and constituents were injected (20 ml of 0.5% Bupivacaine and 10 ml 2% lignocaine). Pharmacological agents used were Metoprolol, NTG or both. SPSS ver 16 was used for statistical analysis. Results: In GIS Group 12 out of 46 needed pharmacological intervention in contrast to G group where 37 out of 45 patients needed pharmacological intervention to achieve hemodynamic goal. Second objective was post op pain relief. In Group G 26 patients out of 45 needed both NSAID and opiates& 19 needed only NSAIDS in first 12 hours post op. In Group GIS only 05 patients out of 46 needed NSAIDS and 2 also needed opiates in first 12 hours. Applying unpaired t test the value of t test was found to be 46.35 and it was highly significant with P value <0.05 (p: 0.000). SPSS ver 16 was used. Conclusion: Our results clearly indicate that goals like hemodynamic stability and adequate pain relief in post-operative period can be achieved with ISB prior to GA marginalizing the use of hypotensive pharmacological drugs.

Keywords: General anesthesia (GA), Interscalene Brachial Plexus Nerve Block (ISBN), Shoulder Arthroscopy, hypotensive hemodynamics, postop pain relief, hypotensive pharmacological agents, opioids and Non-Steroidal Anti-inflammatory Drugs (NSAID).


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