Postoperative analgesia for arthroscopic shoulder surgery: a prospective randomized controlled study of intraarticular, subacromial injection, interscalenic brachial plexus block and intraarticular plus subacromial injection efficacy
- 1 August 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in European Journal of Anaesthesiology
- Vol. 26 (8), 689-693
- https://doi.org/10.1097/eja.0b013e32832d673e
Abstract
The aim of the present study was to compare the new combination of intraarticular + subacromial injection, with intraarticular, subacromial injection and interscalenic brachial plexus block as postoperative analgesia in shoulder arthroscopy. One hundred and twenty patients scheduled for shoulder arthroscopy were enrolled and randomly assigned to one of five groups: intraarticular, subacromial, interscalenic brachial plexus block (IBPB), intraarticular + subacromial (intraarticular + subacromial) injection or a control group. All patients received standardized general anaesthesia and all the injections were given with the same dose and volume of local anaesthetic. The number of boluses (fentanyl 1 μg kg−1) delivered by a patient-controlled analgesia pump applied at the end of the surgery and the visual analogue pain score (VAPS) at 0, 2, 4, 6, 12, 18 and 24 h after the intervention were recorded. A patient satisfaction score was also assessed at 24 h. Mean bolus consumption, compared with control group, was significantly less in all groups (P P These results confirm the analgesic efficacy of IBPB for shoulder surgery. Nonetheless, the combination of intraarticular and subacromial infiltration, studied for the first time, appears to be a clinically valid alternative with no clinical meaningful adverse effects.Keywords
This publication has 16 references indexed in Scilit:
- Perioperative Interscalene Block Versus Intra-Articular Injection of Local Anesthetics for Postoperative Analgesia in Shoulder SurgeryRegional Anesthesia & Pain Medicine, 2008
- Interscalene Regional Anesthesia for Shoulder SurgeryThe Journal of Bone & Joint Surgery, 2005
- Pain Relief After Arthroscopic Shoulder Surgery: A Comparison of Intraarticular Analgesia, Suprascapular Nerve Block, and Interscalene Brachial Plexus BlockAnesthesia & Analgesia, 2004
- Patient-controlled ropivacaine analgesia after arthroscopic subacromial decompressionArthroscopy: The Journal of Arthroscopic & Related Surgery, 2004
- The difficulties of ambulatory interscalene and intra-articular infusions for rotator cuff surgery: a preliminary reportCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 2003
- Subacromial and intra-articular morphine versus bupivacaine after shoulder arthroscopyArthroscopy: The Journal of Arthroscopic & Related Surgery, 2002
- Interscalene Brachial Plexus Block with Continuous Intraarticular Infusion of RopivacaineAnesthesia & Analgesia, 2001
- The pain control infusion pump for postoperative pain control in shoulder surgeryArthroscopy: The Journal of Arthroscopic & Related Surgery, 2000
- The Safety and Efficacy of Intrabursal Oxycodone and Bupivacaine in Analgesia After Shoulder SurgeryRegional Anesthesia & Pain Medicine, 1998
- Interscalene Brachial Plexus BlockAnesthesia & Analgesia, 1970