Purpose: Elderly patients are uniquely vulnerable and particularly sensitive to the stress of trauma, hospitalization, surgery and anesthesia. Because the elderly are also at higher risk of adverse consequences from surgery and unrelieved or undertreated pain, the purpose of this study was to investigate the effect of general and local anesthesia on postoperative pain control.
Methods: This is a retrospective study of patients older than 65 years who underwent shoulder surgery between 2014 and 2017. Patients were divided into two groups: group G (n=85) with general anesthesia, and group R (n=65) with surgery under interscalene block. The choice of anesthesia was determined by the patient\'s choice after providing adequate explanation and time before surgery. Group G received standard anesthesia with propofol, rocuronium, and desflurane. Group I was injected with 20 ml of 2% mepivacaine using ultrasound to perform interscalene block. The preoperative demographics and postoperative pain were analyzed.
Result: The patients with older age were more likely to choose regional anesthesia for surgery (p <0.001). Operative time (p = 0.015) and anesthetic time (p = 0.002) were statistically analyzed to be less in regional anesthesia. There was no statistical difference between the patients\' gender and length of hospital stay. Postoperative pain was lower in the group R than group G in the post anesthetic care unit (p<0.001), 6 hours (p=0.02), and 36 h (p<0.001) postoperatively, but the pain level from 12, 18, 24, and 48 h postoperatively was not significant between the two groups (p>0.05). There was no statistically significant difference between the two groups at 1 month and 3 months after surgery.
Conclusions: There were differences in early postoperative pain between general and regional anesthesia for shoulder surgery in elderly patients. In elderly patients who are susceptible to pain, regional anesthesia may be more effective in controlling pain than general anesthesia.