For Outpatient Rotator Cuff Surgery, Nerve Block Anesthesia Provides Superior
Same-Day Recovery over General Anesthesia
Beklen Kerimoglu, MD, Pelin Emine Karaca, MD, Paul Hobeika, MD, Richard Claudio, MD, Admir
Hadzic, MD, PhD

Background: Both general (GA) and nerve block anesthesia are effective for shoulder surgery. For outpatient surgery, it is important to determine which technique provides more efficient recovery. Our goal was to compare nerve block with GA with respect to speed and quality of recovery after rotator cuff surgery.
Methods: In this clinical trial, 50 consenting outpatients (18-70 years), were randomized to receive either fast-track GA followed by bupivacaine (0.25%) wound infiltration, or interscalene brachial plexus block (ropivacaine 0.75%), under standardized protocols for each. Blinded recovery room nurses performed the assessments, and rated patient eligibility for bypass of the phase-1 postanesthesia care unit (PACU). The primary outcome measure was time-to-home readiness. Other same-day recovery outcomes included phase- 1 PACU bypass rate, severity of and treatment for pain, and times to ambulation and discharge home.
Results: Patients who received nerve block (versus GA) bypassed PACU more frequently (76% vs. 16%, P < 0.001), reported less pain, ambulated earlier, had shorter time-to-home readiness (123 vs. 286 minutes, P< 0.001) and had no unplanned hospital admissions (vs. 4 of 25 patients who underwent GA, P = 0.05),
Figure 1.

Legend: Data are presented as n (%) for discrete variables, mean ± standard deviation for continuous variables.
Boldfaced variables indicate the primary outcome measures for this study, and data presented include 95% confidence intervals (lower bound, upper bound).
ISB: interscalene block; GA: general anesthesia
*From end of procedure
Conclusions: Nerve block anesthesia for outpatient rotator cuff surgery provides several
same-day recovery advantages over general anesthesia.

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