Suprascapular Nerve Block Versus Interscalene Block as Analgesia After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Noninferiority Trial
| Autor: | Thomas W. Bauer, Asuka Desroches, Philippe Hardy, Shahnaz Klouche, Thomas Waitzenegger, Charles Schlur |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Narcotics medicine.medical_specialty Visual Analog Scale Visual analogue scale law.invention Rotator Cuff Injuries 03 medical and health sciences Arthroscopy 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law medicine Humans Orthopedics and Sports Medicine Rotator cuff Ropivacaine Single-Blind Method Anesthetics Local Brachial plexus block 030222 orthopedics Pain Postoperative medicine.diagnostic_test Morphine business.industry Rotator cuff injury Middle Aged medicine.disease Amides Brachial Plexus Block Drug Utilization Surgery medicine.anatomical_structure Pneumothorax Anesthesia Female business medicine.drug |
| Zdroj: | Arthroscopy : the journal of arthroscopicrelated surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 32(11) |
| ISSN: | 1526-3231 |
| Popis: | Purpose To compare the efficacy of suprascapular nerve block (SSB) and interscalene block (ISB) as postoperative analgesia within the first 24 hours after arthroscopic supraspinatus and/or infraspinatus tendon repair. Methods A single-blind, randomized controlled study was performed between 2013 and 2014. The inclusion criteria were arthroscopic supraspinatus and/or infraspinatus tendon repair confirmed intraoperatively, with or without associated procedures, and informed consent. The exclusion criteria were a previously operated shoulder, repair of the subscapularis tendon, and an allergy to local anesthetics. ISB was performed under ultrasound guidance by an anesthesiologist, whereas SSB was performed based on specific anatomic landmarks by a surgeon. The primary evaluation criterion was mean shoulder pain score during the first postoperative 24 hours assessed on a visual analog scale by the patient. The secondary criteria were complications of locoregional anesthesia, the use of analgesics in the recovery room (the first 2 hours) until postoperative day 7, and pain (visual analog scale) during the first week. Forty-four patients were needed for this noninferiority study. An institutional review board approved the study. Results Seventy-four patients were randomized, and 59 met the intraoperative inclusion criteria. Six patients were excluded (1 for pneumothorax after ISB, 1 for unsuccessful SSB, and 4 for incomplete questionnaires). None of the patients were lost to follow-up. There was no significant difference between the SSB and ISB groups in mean pain score for the first 24 hours (P = .92) or the first 7 days (P = .05). However, there was significantly less pain in the ISB group in the recovery room (P = .01). Consumption of analgesics was comparable between the groups, but the SSB group took significantly more morphine in the recovery room. Conclusions In this prospective, randomized controlled study, SSB was as effective as ISB for mean pain control within the first 24 hours but ISB was more effective in relieving pain in the recovery room after arthroscopic supraspinatus and/or infraspinatus tendon repair. Level of evidence Level I, therapeutic, randomized controlled study. |
| Databáze: | OpenAIRE |
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