INTERSCALENE ANESTHESIA FOR SHOULDER ARTHROSCOPY IN A COMMUNITY-SIZEDMILITARY HOSPITAL

The first 100 consecutive shoulder arthroscopic procedures performed u nder interscalene anesthesia at a small community-sized military hospi tal are the basis of this report. This method of anesthesia was compar ed with 100 shoulder arthroscopies performed in a previous 2-year time period under general anesthesia. A variety of arthroscopic and subseq uent open reconstructive procedures about the shoulder were performed using both techniques, Using the interscalene method, 87 regional bloc ks were entirely successful. Thirteen patients required conversion to general anesthesia for adequate pain control; however, 4 of these had a complete block in the recovery room and required no postoperative na rcotics. Seven patients required supplementation with local anesthetic when an open procedure became necessary. There were no major complica tions. Minor complications included 5 patients with transient Horner's syndrome, 4 patients who experienced anxiety, which was controlled wi th sedation, and 3 with nausea or pruritus. Interscalene anesthesia pr ovided excellent intraoperative and postoperative analgesia with low m orbidity. On a subsequent questionnaire, all patients with a successfu l block reported that they were extremely satisfied with their experie nce. Ten patients who had previous shoulder surgery under general anes thesia preferred the interscalene method. In summary, interscalene ane sthesia proved to be an excellent method of anesthesia for shoulder ar throscopy. The technique is reproducible within the resources availabl e in most community-level hospitals.