A comparison between interscalene and costoclavicular blocks for pain relief after shoulder surgery

AIM: Shoulder surgeries are among the most painful surgical procedures in orthopedic practice. Interscalene brachial plexus block, although the most commonly utilized regional anesthesia technique for alleviating pain following shoulder surgery, may result in complications such as hemidiaphragmatic paresis, hoarseness. More distal blocks along the brachial plexus may provide postoperative analgesia while potentially having less effect on respiratory functions. The aim of this study is to determine whether there are differences in postoperative pain scores and opioid consumption between interscalene block (ISB) and costoclavicular brachial plexus block (CCB). MATERIALS AND METHODS: Following ethical approval, a total of 62 patients undergoing for shoulder surgery under general anesthesia between 01.11.2022 and 01.11.2023 were divided into two groups following written informed consent, with one group receiving ISB and the other group receiving CCB. A blinded researcher recorded pain scores at postoperative 0.5, 1, 6, 12, 18, and 24 hours. Demographic data of patients, postoperative opioid consumption, time to first analgesic request, rescue analgesic requirements, adverse effects and hemodynamic parameters were statistically compared. RESULTS: In both groups, VAS pain scores were similar at 0.5., 1., 6., 12., 18. and 24. hours (p > 0,05). Postoperative opioid consumption was significantly lower in the ISB group compared to the CCB group. In the ISB group, the incidence of shortness of breath and the rate of block-related complications (Horner's syndrome, hoarseness, shortness of breath) were found to be significantly higher compared to the CCB group. CONCLUSION: Although postoperative opioid consumption was higher in the CCB group, postoperative pain scores were found to be similar between the two groups. Complications were less common in the CCB group. CCB may be a preferable choice for providing analgesia after shoulder surgery in patients where the preservation of lung function is a priority.