Interscalene Block Enhances Wound Healing, Modulates Immune Response, and Accelerates Recovery After Shoulder Surgery
Bibliographic record
Abstract
Abstract Background Shoulder surgeries are among the most painful orthopedic procedures, and optimal perioperative management is crucial for recovery. Interscalene block (ISB) is widely used for analgesia, yet its effects on wound healing and postoperative immune function remain poorly defined. This study aimed to determine whether ISB enhances wound healing, modulates immune responses, and improves recovery outcomes compared with general anesthesia (GA). Methods This study is a prospective, randomized, controlled clinical trial designed to evaluate the effects of interscalene block on wound healing and postoperative immune response in patients undergoing elective open shoulder surgery.Thirty-four patients undergoing elective rotator cuff repair were randomly assigned to GA (n = 17) or ISB (n = 17) via sealed-envelope randomization. Wound healing was assessed using the Toronto Symptom Assessment System for Wounds (TSAS-W) on postoperative days 5 and 14. Immune response was evaluated by platelet count and serum levels of IL-1, IL-2, TNF-α, EGF, TGF-β, and PDGF at baseline, 24, and 48 hours postoperatively. Secondary outcomes included postoperative pain (VAS), mobilization times, analgesic consumption, and incidence of nausea and vomiting. Statistical analyses incorporated parametric and non-parametric tests, repeated measures analysis, chi-square/Fisher’s exact tests, Bonferroni correction, and effect size calculations (p < 0.05). Results ISB significantly accelerated wound healing, with lower TSAS-W scores on days 5 and 14 compared with GA (p < 0.05). Postoperative platelet counts and levels of IL-1, IL-2, EGF, TGF-β, and PDGF were significantly higher in the ISB group at 24 and 48 hours (p < 0.05), whereas TNF-α remained unchanged. ISB also provided superior analgesia, reflected by lower VAS scores, reduced analgesic consumption, faster mobilization, and decreased incidence of postoperative nausea and vomiting (all p < 0.05). Conclusion Interscalene block not only provides effective analgesia but also enhances wound healing and modulates immune function, promoting faster and safer recovery after shoulder surgery. These findings support ISB as a multifaceted perioperative intervention with benefits beyond pain control.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".