Efficacy of interscalene block combined with multimodal pain control for postoperative analgesia after rotator cuff repair

PURPOSE: The purpose of this study was to identify the effectiveness of multimodal pain control method in an early phase after arthroscopic rotator cuff repair, under interscalene brachial plexus block, this study was performed.MATERIALS AND METHODS: The study was progressed with the 80 cases of arthroscopic rotator cuff repair. Interscalene brachial plexus block was used to all of the 80 cases and patients were divided into 2 groups. Group A consisted of patients injected with bupivacaine, through subacromial space catheter after surgery, and group B consisted of patients with additional method of multimodal pain control using oral opioids, acetaminophen-tramadol complex and selective COX2 inhibitor. Subacromial cathter was removed after injection in both groups. The pain during the day time and night time was compared on the operation day, postoperative 1st, 2nd, 3rd day and 2nd weeks, and it was measured with VAS (visual analogue scale) score. Additionally, the number of ketolorac injection and side-effect related to analgesics was compared between the 2 groups.RESULTS: The mean VAS score of night time on the operation day and day/night time pain of the 1st, 2nd, 3rd day and 2nd weeks was 7.4, 7.0/6.8, 4.5/5.2, 4.8/5.0, 2.2/2.7 on group A and 6.5, 4.3/5.4, 3.2/4.3, 3.0/4.1, 2.4/2.5 on group B, respectively. Significant difference was observed in the night pain on the operation day, 1st, 2nd, 3rd day time and 1st night time pain (p<.05). The average number of ketololac injection was 1.1 and 0.5 in each group, and there was no difference in the frequency of side effects.CONCLUSION: Multimodal pain control method, after arthroscopic rotator cuff repair, showed an effective early pain control and improved patients' satisfaction.

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Comparison of Analgesic Efficacy of Ultrasound-Guided Interscalene Block Versus Continuous Subacromial Infusion for Postoperative Analgesia Following Arthroscopic Rotator Cuff Repair Surgeries: A Randomized Trial

Cureus ◽

10.7759/cureus.13500 ◽

2021 ◽

Author(s):

Suman Saini ◽

Anju Gupta ◽

Shruti Mahesh Rao ◽

Bhavya Krishna ◽

Saveena Raheja ◽

...

Keyword(s):

Rotator Cuff ◽

Randomized Trial ◽

Postoperative Analgesia ◽

Rotator Cuff Repair ◽

Analgesic Efficacy ◽

Arthroscopic Rotator Cuff Repair ◽

Interscalene Block ◽

Ultrasound Guided ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

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Continuous bilateral subomohyoid suprascapular nerve blocks for postoperative analgesia for bilateral rotator cuff repair: a case report

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-021-02050-x ◽

2021 ◽

Author(s):

Shalini Dhir ◽

MarieEve LeBel ◽

Rosemary Ann Craen

Keyword(s):

Case Report ◽

Rotator Cuff ◽

Postoperative Analgesia ◽

Rotator Cuff Repair ◽

Suprascapular Nerve ◽

Nerve Blocks ◽

Cuff Repair

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Oral Ketorolac as an Adjuvant Agent for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair: A Prospective, Randomized, Controlled Study

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/jaaos-d-20-01432 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Lakshmanan Sivasundaram ◽

Sunita Mengers ◽

Nikunj N. Trivedi ◽

John Strony ◽

Michael J. Salata ◽

...

Keyword(s):

Postoperative Pain ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Pain Control ◽

Arthroscopic Rotator Cuff Repair ◽

Controlled Study ◽

Postoperative Pain Control ◽

Randomized Controlled ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

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Continuous Interscalene Analgesia for Rotator Cuff Repair: A Retrospective Comparison of Effectiveness and Cost in 205 Patients from a Multi-Provider Private Practice Setting

Anaesthesia and Intensive Care ◽

10.1177/0310057x0803600606 ◽

2008 ◽

Vol 36 (6) ◽

pp. 786-791 ◽

Cited By ~ 19

Author(s):

M. J. Fredrickson ◽

A. W. Stewart

Keyword(s):

Rotator Cuff ◽

Local Anaesthetic ◽

Rotator Cuff Repair ◽

High Volume ◽

Interscalene Block ◽

Private Care ◽

Continuous Interscalene ◽

Anaesthesia Care ◽

Clinical Records ◽

Cuff Repair

Several barriers exist to the routine use of continuous interscalene block (CISB) for postoperative analgesia following rotator cuff repair. There is a perception that the technique is feasible only for single operators exposed to a high volume case load. The aim of this retrospective review was to compare the three commonly employed analgesic techniques following rotator cuff repair in a multi-provider setting. The techniques studied were CISB, combined single injection interscalene block with postoperative intermittent intra-articular local anaesthetic infiltration (SSISB/IA) and intermittent intra-articular only local anaesthetic infiltration (IA). The clinical records of 205 consecutive patients having open rotator cuff repair over an 18-month period in two private care facilities were reviewed. The primary outcome endpoint was total opioid/tramadol consumption during the period of an overnight hospital stay. The median total opioid and tramadol consumption (in intravenous mg equivalents of morphine) from admission to the post anaesthesia care unit until discharge from hospital was 5 mg in the CISB group and 10 mg for the SSISB/IA and IA groups (P <0.0001). The proportion of subjects requiring more than one antiemetic for the same period was 1.9% in the CISB group, 16.4% for the SSISB/IA group and 36.1% for the IA group (P <0.0001). Costs related to the analgesic technique were similar in each group. CISB following rotator cuff repair in a multi-provider setting was associated with reduced total opioid/tramadol and antiemetic consumption, and occurred without a significant increase in the monetary cost.

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