Interscalene Block Enhances Wound Healing, Modulates Immune Response, and Accelerates Recovery After Shoulder Surgery

BackgroundShoulder 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). MethodsThis 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-, EGF, TGF-{beta}, 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/Fishers exact tests, Bonferroni correction, and effect size calculations (p < 0.05). ResultsISB 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-{beta}, and PDGF were significantly higher in the ISB group at 24 and 48 hours (p < 0.05), whereas TNF- 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). ConclusionInterscalene 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.