Jin-Young Park1, Jin-Young Bang2, Kyung-Soo Oh3. 1. NEON Orthopaedic Center, Seoul, South Korea. 2. Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. drbang@paik.ac.kr. 3. Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, South Korea.
Abstract
PURPOSE: The goal of the study was to evaluate the efficacy of additional axillary nerve block (ANB) with suprascapular nerve block (SSNB) and patient-controlled anaesthesia (PCA) with no device assistance after arthroscopic rotator cuff repair. The hypothesis is that patients withintravenous (IV) PCA and the blockade of the two main nerves (SSNB + ANB) experienced lesser pain than patients with IV PCA or IV PCA + SSNB. METHODS: The 114 patients undergoing arthroscopic rotator cuff repair were allocated randomly to three groups as follows: group I, intravenous PCA pumps (only PCA); group II, IV PCA + SSNB using a blind technique (PCA + SSNB); and group III, IV PCA + SSNB + ANB using a blind technique (PCA + SSNB + ANB). Pain visual analogue scale (VAS) scores were evaluated at 1, 6, 12, 24, 36, and 48 post-operative hours. Furthermore, the degree of pain was compared according to cuff tear size. RESULTS: The pain VAS score of group III was lower than that of the other two groups and was significantly lower at post-operative hours 1, 6, and 12. In addition, the larger cuff tear tended to be indicative of greater pain. However, all groups experienced rebound pain. CONCLUSION: PCA + SSNB + ANB using a blind technique is a better pain control method than PCA + SSNB and only PCA during the initial 12 post-operative hours. PCA + SSNB + ANB is a cost-effective, time-saving, and easily performed method for post-operative pain control as an axis of multimodal pain control strategy. LEVEL OF EVIDENCE: II.
RCT Entities:
PURPOSE: The goal of the study was to evaluate the efficacy of additional axillary nerve block (ANB) with suprascapular nerve block (SSNB) and patient-controlled anaesthesia (PCA) with no device assistance after arthroscopic rotator cuff repair. The hypothesis is that patients with intravenous (IV) PCA and the blockade of the two main nerves (SSNB + ANB) experienced lesser pain than patients with IV PCA or IV PCA + SSNB. METHODS: The 114 patients undergoing arthroscopic rotator cuff repair were allocated randomly to three groups as follows: group I, intravenous PCA pumps (only PCA); group II, IV PCA + SSNB using a blind technique (PCA + SSNB); and group III, IV PCA + SSNB + ANB using a blind technique (PCA + SSNB + ANB). Pain visual analogue scale (VAS) scores were evaluated at 1, 6, 12, 24, 36, and 48 post-operative hours. Furthermore, the degree of pain was compared according to cuff tear size. RESULTS: The pain VAS score of group III was lower than that of the other two groups and was significantly lower at post-operative hours 1, 6, and 12. In addition, the larger cuff tear tended to be indicative of greater pain. However, all groups experienced rebound pain. CONCLUSION:PCA + SSNB + ANB using a blind technique is a better pain control method than PCA + SSNB and only PCA during the initial 12 post-operative hours. PCA + SSNB + ANB is a cost-effective, time-saving, and easily performed method for post-operative pain control as an axis of multimodal pain control strategy. LEVEL OF EVIDENCE: II.
Authors: Julie Y Bishop; Mark Sprague; Jonathan Gelber; Marina Krol; Meg A Rosenblatt; James Gladstone; Evan L Flatow Journal: J Bone Joint Surg Am Date: 2005-05 Impact factor: 5.284
Authors: Jeffrey Kay; Muzammil Memon; Thomas Hu; Nicole Simunovic; Andrew Duong; James Paul; George Athwal; Olufemi R Ayeni Journal: Orthop J Sports Med Date: 2018-12-28
Authors: Olufunke Dada; Alicia Gonzalez Zacarias; Corinna Ongaigui; Marco Echeverria-Villalobos; Michael Kushelev; Sergio D Bergese; Kenneth Moran Journal: Int J Environ Res Public Health Date: 2019-09-05 Impact factor: 3.390
Authors: Vincenzo Candela; Umile Giuseppe Longo; Calogero Di Naro; Gabriella Facchinetti; Anna Marchetti; Gaia Sciotti; Giulia Santamaria; Ilaria Piergentili; Maria Grazia De Marinis; Ara Nazarian; Vincenzo Denaro Journal: Int J Environ Res Public Health Date: 2020-09-20 Impact factor: 3.390