Objective: This study aimed to evaluate the effects of dexmedetomidine sedation and general anesthesia combined with ultrasound-guided interscalene brachial plexus block (ISB) on perioperative patient satisfaction, surgeon comfort, pain management, and length of hospital stay in the surgical management of proximal humeral fractures.
Materials and Methods: Patients who underwent surgical treatment for proximal humerus fractures between January 2021 and June 2024 were retrospectively evaluated. All procedures were performed following ISB, either in combination with dexmedetomidine sedation or general anesthesia. A total of 72 patients were included in the final analysis (Group I: ISB with dexmedetomidine sedation, n=35; Group II: ISB with general anesthesia, n=37). Baseline demographic and clinical characteristics were comparable between the groups. Perioperative outcomes, including the patient satisfaction score (PSS) and surgeon comfort score (SCS), were assessed using 10-point numerical rating scales. Additional outcomes included postoperative pain scores, opioid consumption, motor function recovery, complications, and length of hospital stay.
Results: The PSS was significantly higher in Group I, whereas the SCS was significantly higher in Group II (both p<0.001). Intraoperative hypotension and postoperative nausea and vomiting occurred more frequently in Group II than in Group I, with statistically significant differences between the groups (p<0.05). In contrast, no significant intergroup differences were observed in perioperative numerical rating scale scores, total systemic analgesic consumption, time to recovery of motor strength, or length of hospital stay (p>0.05).
Conclusion: ISB combined with sedation provided greater patient satisfaction and fewer perioperative complications, whereas general anesthesia improved surgeon comfort. These findings suggest that ISB with sedation is a preferable approach for patients undergoing shoulder surgery.