Ambulante Schulterarthroskopie durchgeführt in alleiniger Allgemeinanästhesie oder als Kombination mit einem interskalenären Plexusblock

Outpatient shoulder arthroscopy performed in general anesthesia alone or in combination with an interscalene Plexusblock

by Hauke Onko Janssen
Doctoral thesis
Date of Examination:2015-12-08
Date of issue:2015-12-03
Advisor:Prof. Dr. José Hinz
Referee:Prof. Dr. José Hinz
Referee:PD Dr. Tim Alexander Walde
Persistent Address: http://dx.doi.org/10.53846/goediss-5393

 

 

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Abstract

English

Investigation of anesthesia for shoulder arthroscopy in beach chair position in outpatient surgery. Comparison of general anesthesia alone with combination of general anesthesia with interscalene plexus block. 83 patients were included, 41 patients in the general anesthesia group, 42 patients in the group with the combination of general anesthesia with interscalene plexus block. All were classified as ASA I-II. We considered hemodynamic parameters and the occurrence of severe hypotension or bradycardia (Bezold-Jarisch-Reflex), process times and postoperative complications like pain and postoperative nausea and vomiting. In addition we analyzed the satisfaction of the patients with a questionnaire. We could show a positive effect on postoperative pain in the group of patients with the combination anesthesia, without a higher incidence of severe hypotension or the occurrence of the Bezold-Jarisch-Reflex. Also process times can be improved if logistical arrangements like an additional anesthesiologist and an additional room to perform the plexus block are available. In conclusion the combination of general anesthesia with an interscalene plexus block can be safely performed in outpatient ASA I and ASA II patients, with a positive effect on postoperative pain and a high patient acceptance. 
Keywords: interscalene brachial plexus; Bezold-jarisch reflex; Outpatient surgery; Regional anaesthesia; Shoulder surgery
 
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