# A survey of anaesthetic management of regional anaesthesia for patients undergoing arthroscopic shoulder surgery in Australia

## TL;DR

This study surveys how anesthesiologists in Australia and New Zealand manage regional anesthesia for shoulder surgery, finding common use of interscalene blocks and ultrasonography.

## Contribution

The study provides a snapshot of current regional anesthesia practices for arthroscopic shoulder surgery in Australia and New Zealand.

## Key findings

- Most respondents (85.1%) routinely use regional blocks for shoulder surgery.
- Interscalene blocks with ultrasonography are the most common technique.
- Variation exists in monitoring practices and patient-controlled analgesia use.

## Abstract

The Australian and New Zealand College of Anaesthetists recommends standards of monitoring and conduct for regional anaesthesia but does not endorse specific regional techniques. While the interscalene block is the de-facto standard technique, there are numerous established and novel alternatives. Regional block choice and block-related variables (local anaesthetic type, dose, volume, adjuncts) are subject to individual and institutional practices.

Using a 30-question survey, we aimed to create a snapshot of current regional anaesthesia practice for patients undergoing arthroscopic shoulder surgery across Australia and New Zealand.

Among 134 anaesthetist respondents, 85.1% routinely placed a regional block for arthroscopic shoulder surgery. 91.2% performed interscalene blocks. Ropivacaine 0.375% and 0.75% were the most common concentrations and type. Regional anaesthesia under light sedation and general anaesthesia were performed by 47.4% and 30.7% block-respondents respectively. 96.5% of block-respondents used ultrasonography. 49.1% of block-respondents recorded written consent. 86.0% always performed a consent/site/side check. Standard monitoring was variably applied for blood pressure, electrocardiography and end-tidal carbon dioxide monitoring. Postoperatively, patient-controlled analgesia was not routinely prescribed.

Variation exists for regional anaesthesia techniques for arthroscopic shoulder surgery with most performing interscalene blocks with ultrasonography. This study highlights topics of debate including level of consciousness during block performance and overall adherence to monitoring recommendations, so as to ensure patient and anaesthetist safety is upheld.

Not applicable.

The online version contains supplementary material available at 10.1186/s12871-025-03459-3.