There are different techniques of interscalene brachial plexus block, we aimed to evaluate the effectiveness of 3 of them as analgesia during shoulder arthroscopy surgery under general anesthesia.

Prospective randomized controlled study

There were 4 groups included in our study:

Group N: nerve stimulator guided interscalene brachial plexus block was done Group U: ultrasound guided interscalene brachial plexus block was done Group NU: dual guidance (using both nerve stimulator and ultrasound) Group C: control group We assessed in each group: heart rate, noninvasive blood pressure, time needed for block, onset of sensory and motor power loss and their offset, and finally patient satisfaction.

Inclusion Criteria:

• Age: 18-65 years old.
• Sex: Both sexes.
• ASA I & II.

Exclusion Criteria:

• - Patient refusal.
• Bleeding disorders.
• Damage or disease of the brachial plexus.
• ASA more than II.
• Pre-existing peripheral neuropathy.
• Patients with neuromuscular diseases.
• Patients with known hypersensitivity to drugs of the study.
• Patients with local skin infection at the site of injection.
• Psychiatric diseases interfering with evaluation of the block.