The assessment of haemodynamic stability, gas exchange parameters, and the quality of postoperative analgesia in patients undergoing arthroscopic shoulder joint surgery in two different types of anaesthesia – preliminary research

Introduction
There are several methods available to conduct anaesthesia in patients undergoing arthroscopic shoulder joint surgery. The main aim of anaesthesia is to reach controlled hypotension to reduce bleeding in the operating field.

Aim of the research
To assess haemodynamic stability in patients undergoing arthroscopic shoulder joint surgery in two different types of anaesthesia: complex general anaesthesia and complex general and regional anaesthesia.

Material and methods
The research included 20 patients who underwent arthroscopic shoulder joint surgery in St. Rafal’s Provincial Specialist Hospital in Czerwona Gora. Patients were randomly assigned into two groups – A and B. Patients from group A were subjected to complex general anaesthesia by infusion of remifentanil. In group B patients, brachial plexus block was performed. During anaesthesia haemodynamic parameters were monitored, and gas exchange parameters, the level of lactates, and the effectiveness of post-operative analgesia were assessed.

Results
Heart rate (HR) parameters between the two groups differed substantially after 30 min. U Mann-Whitney Test indicated salience p = 0.009. In group A HR and mean arterial pressure parameters were similar, which proves better haemodynamic stability. In group A the arterial blood pH value showed similar values (p = 0.001), which indicates better stability of the acid-base balance. Post-operative pain in group A was more persistent than in group B and required a supply of morphine in a higher dose.

Conclusions
The application of remifentanil results in higher haemodynamic stability in comparison to anaesthesia with brachial plexus block; however, the usage of block results in better post-operative analgesia in comparison to the first method.