The assessment of the effectivenes of interscalen brachial plexus block on postthoracotomy shoulder pain

The aim of this study was to observe the effect of interscalen brachial plexusblock on postthoracotomy ipsilateral shoulder pain. 40 patients with postoperativeipsilateral shoulder pain who will undergo elective thoracotomy operation and under riskgroup ASA I-III were included in the study. The patients were divided into 2 groupsrandomly as Group I (interscalen block, n=20) and Group II(NSAID, n=20). By applyinginterscalen block with 25ml 0.25% levobupivacain to one group and by administring 75mg diclofenac sodium to the other group. We compared the effect of both methods on theshoulder pain.Following the anesthetic induction, the invazive blood pressure had beenmonitored and later, HR, SAP, DAP, MAP, EtCO2 values were noted on 3th, 5 th, 15th, 30 th, 45 th, 60 th, 120 th, 180 th minute after induction and during extubation.Incision area pain and shoulder pain of the patients, taken to the postoperativeintensive care, were evaluated with VNS score and after that interscalen block orNSAID were applied randomly.Postoperative HR, SAP, DAP, MAP, SPO2values in 30th minute, 2nd hr, 4thhr, 6 th hr, 12 th hr and 24 th hr; postoperative initial morphine requirement time,total morphine requirement, patient satisfaction, interscalen block applicationtime/non-steroid application time, postoperative blood gas parameters in 2nd hrand 24 th hr were all noted.While a significant decrease of the VNS scores were observed in 30 th min,2nd, 4 th, 6 th, 12 th and 24 th hr with respect to the initial values on the patients withinterscalen block, the decrease was only observed in 12 th and 24 th hr on thepatients who were given im diklofenac sodium (p<0.05). Between these twogroups, the significant decrease of the VNS scores had been found in the groupwith interscalen block (p<0.05).No significant difference was observed on initial analgasia requirementbetween these two groups. However total analgesia consumption was less on thegroup with interscalen block. (p<0.05).As a result, we found that the interscalen block with 20ml 0.25%levobupivacain may be used as an effective treatment for the patients withipsilateral shoulder pain after thoracotomy in the first 24 hours.