Celecoxib versus parecoxib versus oxycodone in pain control for transcatheter chemoembolization in patients with hepatocellular carcinoma.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 509-509
Author(s):  
Ming Zhao ◽  
Ning Lyu ◽  
Yanan Kong ◽  
Xiaoxian Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Trial ◽  
Analgesic Effect ◽  
Pain Control ◽  
Morphine Consumption ◽  
Pain Scores ◽  
Time Period ◽  
Significant Difference ◽  
Inflammatory Drugs ◽  
Cox 2

509 Background: Abdominal pain is one of the most common side effects of transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma. Previous studies reported that perioperative controlled-release oxycodone (CRO) intake or administration of parecoxib resulted in adequate pain control after TACE. However, there are currently no studies comparing opioids with nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling postoperative pain. Therefore, we conducted a clinical trial to compare the analgesic effect and safety among celecoxib (oral COX-2 inhibitor), parecoxib (injectable COX-2 inhibitor), and CRO (oral opioids) in patients undergoing TACE. Methods: The study was a prospective, randomized, paralleled trial in which 213 patients were enrolled between September 2016 and March 2019. Patients were randomly assigned at the ratio of 1:1:1 to receive celecoxib, parecoxib or CRO 1 h before TACE (T0) and once every 12 h for 2 days after TACE. Pain level, morphine consumption and adverse events were evaluated and compared among the three regimens. Results: Highest incidence of pain occurred within the first 12 hours (T12) after TACE. Analysis of pain control showed no significant difference among the mean highest pain scores, percentage distribution of pain categories and mean morphine consumption in the three groups at T0, T12, T24, T36, and T48. At T24, 11 patients (15.7%) in oxycodone group had fever, which was higher than parecoxib regimen (1 patient [1.5%], P = 0.003). At T36, 13 patients (18.6%) in oxycodone regimen had fever, which was higher than celecoxib regimen (2 patients [2.9%], P = 0.003) and parecoxib regimen (1 patient [1.5%], P < 0.001). At T48, 11 patients (15.7%) in oxycodone regimen had fever, which was higher than celecoxib regimen (2 patients [2.9%], P = 0.010) and parecoxib regimen (0 patients, P = 0.001). Conclusions: The results suggested that patients obtained celecoxib, parecoxib or CRO once every 12 hours can have the same level of analgesic effect during each time period of TACE. However, body temperature balance in oxycodone regimen was significantly worse than celecoxib regimen and parecoxib regimen. Clinical trial information: NCT03059238.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals Analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain: A randomized clinical trial

2019 ◽  
Author(s):  
Seyyed Hamid Pakzad Moghadam ◽  
Masoud Pourparizi ◽  
Reza Goujani ◽  
Tayyebeh Mirzaei Khalilabadi ◽  
Ali Ravari ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Intravenous Administration ◽  
Normal Saline ◽  
Analgesic Effect ◽  
Pain Control ◽  
Opioid Analgesic ◽  
Saline Control ◽  
Control Group ◽  
Significant Difference

Abstract Background Pain control after every surgery, especially cesarean is highly important, and physicians are striving to discover pain control methods using the least amount of opioid and Paracetamol is a non-opioid analgesic with few complications. The present study was aimed to investigate the analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain.Methods This randomized double-blind clinical trial was conducted on 240 pregnant women under spinal anesthesia who were candidate for elective cesarean. The patients’ weight, height, age and body mass index (BMI) were recorded, and patients were randomly divided into two equal groups (n=120). In the first group, 10 mg/kg paracetamol in 100cc normal saline (paracetamol group) and in the second group 100cc normal saline (control group) administered 15 minutes before surgery intravenously. Blood pressure, pulse rate, chills and nausea were recorded during and 1 hour after surgery, and pain visual analogue scale (VAS) and need for additional analgesic were recorded 1, 2, 4, 6, 12 and 24 hours after surgery.Results No significant difference was found between the two groups in frequency of chills and nausea (p>0.05). Mean pethidine consumed was lower in paracetamol group than control group but not significantly. Systolic blood pressure of both groups during surgery and one hour after surgery did not show a significant difference, but diastolic blood pressure was significantly lower in paracetamol group 15 minutes (p=0.046) and 60 minutes after surgery (p=0.042) than control group. The mean scores of pain were significantly lower in paracetamol group than control group 6 hours (0.008) and 24 hours (p=0.038) after surgery.Conclusions Within the limitations of the current study, preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain within 24 hours.

scholarly journals Analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain: A randomized clinical trial

2020 ◽  
Author(s):  
Seyyed Hamid Pakzad Moghadam ◽  
Masoud Pourparizi ◽  
Reza Goujani ◽  
Tayyebeh Mirzaei Khalilabadi ◽  
Ali Ravari ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intravenous Administration ◽  
Normal Saline ◽  
Analgesic Effect ◽  
Pain Control ◽  
Opioid Analgesic ◽  
Saline Control ◽  
Control Group ◽  
Medical Sciences ◽  
Significant Difference

Abstract Background: Pain control after every surgery, especially cesarean is very important, and physicians are striving to discover pain control methods using the least amount of opioid. Paracetamol is a non-opioid analgesic with few complications. The present study was aimed to investigate the analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain. Methods: This randomized double-blind clinical trial was conducted on 240 pregnant women under spinal anesthesia who were candidate for elective cesarean. The patients’ weight, height, age and body mass index (BMI) were recorded, and patients were randomly divided into two equal groups (n=120). In the first group, 10 mg/kg paracetamol in 100cc normal saline (paracetamol group) and in the second group 100cc normal saline (control group) administered 15 minutes before surgery intravenously. Blood pressure, pulse rate, chills and nausea were recorded during and 1 hour after surgery, and pain visual analogue scale (VAS) and need for additional analgesic were recorded 1, 2, 4, 6, 12 and 24 hours after surgery. Results : The mean scores of pain were significantly lower in paracetamol group (4.01±2.22) than control group 6 hours (4.83±2.35) (p=0.008) and 24 hours (2.26±1.85 and 2.67±1.80 respectably) (p=0.038) after surgery. Mean meperidine consumed was lower in paracetamol group than control group but not significantly. No significant difference was found between the two groups in frequency of chills and nausea (p>0.05). Conclusions : Within the limitations of the current study, preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain within 24 hours. Trial registration: The proposal of present study approved by the Research Council of Rafsanjan University of Medical Sciences with No. 841 on 2016-11-08 and by the ethics committee of Rafsanjan University of Medical Sciences, with code IR.RUMS.REC.1395.115 on 2016-11-08 (prospectively registered), and approved by the Iranian Registry of Clinical Trial (IRCT) with code IRCT20150519022320N17 on 2019-01-18 (retrospectively registered). https://www.irct.ir

A118G Single Nucleotide Polymorphism of Human μ-Opioid Receptor Gene Influences Pain Perception and Patient-controlled Intravenous Morphine Consumption after Intrathecal Morphine for Postcesarean Analgesia

2008 ◽  
Vol 109 (3) ◽  
pp. 520-526 ◽  
Author(s):  
Alex T. Sia ◽  
Yvonne Lim ◽  
Eileen C. P. Lim ◽  
Rachelle W. C. Goh ◽  
Hai Yang Law ◽  
...  
Keyword(s):  
Opioid Receptor ◽  
Pain Perception ◽  
Intrathecal Morphine ◽  
Receptor Gene ◽  
Mu Opioid Receptor ◽  
Morphine Consumption ◽  
Mu Opioid ◽  
Pain Scores ◽  
Significant Difference ◽  
Intravenous Morphine

Background Previous studies have shown that genetic variability at position 118 of the human mu-opioid receptor gene altered patients' response to intravenous morphine. The purpose of this study was to investigate whether this polymorphism contributes to the variability in response to morphine for postcesarean analgesia. Methods After investigators obtained informed consent, 588 healthy women received 0.1 mg intrathecal morphine for postcesarean analgesia. Their blood samples were genotyped for the A118G polymorphism-A118 homozygous (AA), heterozygous (AG), or homozygous for the G allele (GG). Pain scores, the severity of nausea and vomiting, the incidence of pruritus, and the total self-administered intravenous morphine were recorded for the first 24 postoperative hours. Results Two hundred seventy women (46%) were AA, 234 (40%) were AG, and 82 (14%) were GG. The 24-h self-administered intravenous morphine consumption was lowest in the AA group (P = 0.001; mean, 5.9; 95% confidence interval, 5.1-6.8) versus the AG (8.0; 6.9-9.1) and GG groups (9.4; 7.3-11.5). Pain scores were lowest in the AA group and highest in the GG group, with a statistically significant difference detected between AA, AG, and GG (P = 0.049). Total morphine consumption was also influenced by patients' age and paying status. AA group was associated with the highest incidence of nausea (26 of 272 [9.6%]; P = 0.02) versus the other two groups (13 of 234 [5.6%] and 1 of 82 [1.2%] for AG and GG, respectively). Conclusion Genetic variation at position 118 of the mu-opioid receptor is associated with interindividual differences in pain scores, self-administered intravenous morphine, and the incidence of nausea postoperatively.

Randomised clinical trial comparing the perioperative analgesic efficacy of oral tramadol and intramuscular tramadol in cats

2021 ◽  
pp. 1098612X2110404
Author(s):  
Sébastien H Bauquier
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Analgesic Efficacy ◽  
Randomised Clinical Trial ◽  
Rescue Analgesia ◽  
Exact Test ◽  
Pain Scores ◽  
Significant Difference ◽  
American Society ◽  
Induction Of Anaesthesia

Objectives The aim of this study was to evaluate the analgesic efficacy of oral tramadol in cats undergoing ovariohysterectomy. Methods Twenty-four female domestic cats, American Society of Anesthesiologists class I, aged 4–24 months, were included in this positive controlled, randomised, blinded clinical trial. Cats admitted for ovariohysterectomy were allocated to group oral tramadol (GOT, n = 12) or group intramuscular tramadol (GIMT, n = 12). In GOT, tramadol (6 mg/kg) was given orally 60 mins, and saline was given intramuscularly 30 mins, before induction of anaesthesia. In GIMT, granulated sugar in capsules was given orally 60 mins and tramadol (4 mg/kg) intramuscularly 30 mins before induction of anaesthesia. In both groups, dexmedetomidine (0.007 mg/kg) was given intramuscularly 30 mins before induction of anaesthesia with intravenous propofol. Anaesthesia was maintained with isoflurane in oxygen, and atipamezole (0.037 mg/kg) was given intramuscularly 10 mins after extubation. The UNESP-Botucatu multidimensional composite scale was used to conduct pain assessments before premedication and at 20, 60, 120, 240 and 360 mins post-extubation or until rescue analgesia was given. To compare groups, the 60 min postoperative pain scores and the highest postoperative pain scores were analysed via a two-tailed Mann–Whitney test, and the incidences of rescue analgesia were analysed via a Fisher’s exact test; P <0.05. Results There was no significant difference between groups for the 60 min ( P = 0.68) pain scores. The highest postoperative pain score was higher for GIMT compared with GOT ( P = 0.04). Only two cats required rescue analgesia, both from GIMT. The incidence of rescue analgesia was not significantly different between groups ( P = 0.46). Conclusions and relevance In the present study, preoperative administration of oral tramadol at 6 mg/kg to cats provided adequate analgesia for 6 h following ovariohysterectomy surgery.

scholarly journals Intravenous Paracetamol vs Intranasal Desmopressin for Renal Colic in the Emergency Department: A Randomized Clinical Trial

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3437-3442
Author(s):  
Hamed Basir Ghafouri ◽  
Niloofar Abazarian ◽  
Mohammadreza Yasinzadeh ◽  
Ehsan Modirian
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Pain Score ◽  
Randomized Clinical Trial ◽  
Renal Colic ◽  
Rating Scale ◽  
Pain Scores ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Intranasal Desmopressin

Abstract Objective To evaluate the analgesic efficacy of intranasal desmopressin alone vs intravenous paracetamol in patients referred to the emergency department with renal colic. Design Randomized clinical trial. Setting This study was conducted in the emergency unit of a university hospital. Subjects Patients referred to the emergency room with renal colic. Primary Outcome Effect of intranasal desmopressin in pain relief in comparison with intravenous paracetamol. Methods In this trial, 240 patients diagnosed with renal colic were randomly divided into two groups to compare the analgesic effect of intravenous paracetamol (15 mg/kg) and intranasal desmopressin spray (40 μg). Pain scores were measured by a numeric rating scale at baseline and after 15, 30, and 60 minutes. Adverse effects and need for rescue analgesic (0.05 mg/kg max 3 mg morphine sulphate) were also recorded at the end of the study. Results Three hundred patients were eligible for the study; however, 240 were included in the final analysis. The patients in the two groups were similar in their baseline characteristics and baseline pain scores. The mean pain score after 15 minutes was more reduced and was clinically significant (&gt;3) in the desmopressin group (P &lt; 0.0001). There was no significant difference between mean pain scores in the two groups after 30 minutes (P = 0.350) or 60 minutes (P = 0.269), but the efficacy of the two drugs was significant in terms of pain reduction (&gt;6). Conclusions Our study showed that intranasal desmopressin is as effective as intravenous paracetamol for renal colic pain management; however, significant clinical reduction in pain score occurred faster with intranasal desmopressin.

scholarly journals Periarticular Injection with Bupivacaine for Postoperative Pain Control in Total Knee Replacement: A Prospective Randomized Double-Blind Controlled Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Varah Yuenyongviwat ◽  
Chaturong Pornrattanamaneewong ◽  
Thitima Chinachoti ◽  
Keerati Chareancholvanich
Keyword(s):  
Pain Control ◽  
Controlled Trial ◽  
Ease Of Use ◽  
Morphine Consumption ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Periarticular Injection ◽  
Post Operative Pain ◽  
Significant Difference

Background. Local periarticular injection with bupivacaine alone in TKA has not been studied. Thus, we aimed to examine the effectiveness of local periarticular injection with bupivacaine for post-operative pain control in TKA.Method. Sixty patients undergoing TKA by a single surgeon were randomly assigned into two groups in a double-blind, placebo-controlled study. In the injection group, patients received periarticular injections with 0.25% bupivacaine before wound closure; in the control group, patients received a 0.9% normal saline injection. Both groups received the same anesthetic procedure, post-operative pain control, and rehabilitation protocol.Results. There was a significant reduction in post-operative morphine consumption in the first six hours after the operation (mean 0.9 mg and 2.43 mg,P=0.01), but there was no significant difference in post-operative morphine consumption between six hours and ninety-six hours after the operation, visual analogue scale (VAS) score, morphine side effects during the first 96 hours, length of hospital stay, or complications from morphine consumption.Conclusion. Local periarticular injection with bupivacaine alone before wound closer was shown to be an effective method to improve pain control after TKA with a few complications and ease of use.

scholarly journals Comparative Evaluation of Clonidine as an Adjunct to Ropivacaine for Caudal Block Anaesthesia in Children Undergoing Sub-Umbilical Surgeries

2021 ◽  
Vol 10 (44) ◽  
pp. 3785-3790
Author(s):  
Priyash Verma ◽  
Ravishankar R.B.
Keyword(s):  
Epidural Space ◽  
Pain Control ◽  
Motor Blockade ◽  
Pain Scores ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Key Words Analgesia ◽  
Caudal Epidural

BACKGROUND Studies suggest that clonidine can improve the duration of analgesia, quality of pain control when used with ropivacaine for caudal blocks in children. This study was designed to understand the effects of caudally administered ropivacaine 0.25 % (1ml/kg) alone and ropivacaine 0.25 % (1ml/kg) with clonidine 2 mcg/kg, in children between 2- 10 years. METHODS Sixty children posted for various sub-umbilical surgical procedures were included after written informed consent and ethics committee approval. Children were randomly divided into 2 groups of 30 each: Group R —ropivacaine 0.25 % 1 ml/kg into caudal epidural space and Group RC—ropivacaine 0.25 % 1 ml/kg and clonidine 2 mcg/kg into caudal epidural space. RESULTS The mean age of patients was similar with no statistical difference (4.83 vs 5.36, P = 0.3353). The duration of anaesthesia was significantly longer in the RC group (544.83 minutes vs 268.00 minutes, P < 0.0001). The effect size was very high (Cohen d=23.86). The pain score was comparable up to 1 hour for the two groups. But 2 hours later, the pain scores were significantly lower for the ropivacaine and clonidine groups. The effect on motor blockade was similar in both groups with no motor blockade at 4 hours follow up. 5 cases of urinary retention were seen in the study with no statistically significant difference in terms of complication rate between the two groups. No case of hypotension or bradycardia was seen. There was a significant difference between the two groups in terms of cardiovascular parameters (HR, SBP, DBP) after administration of drugs. CONCLUSIONS The addition of clonidine to ropivacaine for caudal blocks in children was associated with better quality of pain control and a longer duration of analgesia without any additional motor blockade. There was no significant difference seen in terms of complication. KEY WORDS Analgesia Duration, Caudal Analgesia, Clonidine, Pain Control, Ropivacaine.

Randomized double-blind placebo-controlled trial of celecoxib for radiation-induced oral mucositis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9620-9620
Author(s):  
Rajesh V. Lalla ◽  
Linda E. Choquette ◽  
Kathleen F. Curley ◽  
Robert J. Dowsett ◽  
Richard S. Feinn ◽  
...  
Keyword(s):  
Oral Mucositis ◽  
Fixed Effects ◽  
Controlled Trial ◽  
Opioid Analgesics ◽  
T Test ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Pain Scores ◽  
Significant Difference ◽  
Cox 2

9620 Background: Oral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck (H&N) cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to treatment interruptions. Due to the role of inflammatory pathways in the pathogenesis of OM, this study investigated the effect of inhibition of cyclooxygenase-2 (COX-2) on severity and morbidity of OM. Methods: In this randomized double-blind placebo-controlled trial,40 H&N cancer patients were randomized to daily use of 200 mg celecoxib or matched placebo, for the duration of RT. Eligibility criteria included planned RT dose of ≥ 5000 cGy to 2+ areas of the mouth and no contraindication for celecoxib use. The planned sample size of 20 per arm provided 80% power to detect a 1 point difference in mean Oral Mucositis Assessment Scale (OMAS) score (range 0-5) at 5000 cGy RT (primary endpoint), applying a two-tailed, two-sample t-test at the 5% level of significance. Clinical OM, normalcy of diet, pain scores and analgesic use were assessed 2-3 times a week by blinded investigators during the 6-7 week period of RT, using validated scales. Results: Twenty subjects were randomized to each arm, which were similar with respect to tumor location, radiation dose, and concomitant chemotherapy. In both arms, mucositis and pain scores increased over the course of RT. Intent-to-treat analyses demonstrated no significant difference in mean (SD) OMAS scores at 5000 cGy [celecoxib 1.32 (0.71), placebo 1.27 (0.86), p = 0.83, two sample t-test]. There was also no difference between the celecoxib and placebo arms respectively, in mean OMAS scores over the period of RT (SD) [0.98(0.77) & 0.97 (0.86), p = 0.84], mean worst pain scores [3.38 (3.07) & 3.31 (3.32), p = 0.83], mean normalcy of diet scores [5.43 (3.86) & 5.11(3.94), p = 0.65], or mean daily opioid medication use in IV morphine equivalents [19.08 (16.57) & 20.48 (19.07), p = 0.48], all by linear mixed model fixed effects regression analysis. There were no SAEs attributed to celecoxib use. Conclusions: Daily use of a selective COX-2 inhibitor, during the period of RT for H&N cancer, did not reduce the severity of clinical OM, pain, dietary compromise or use of opioid analgesics. Clinical trial information: NCT00698204.

Suprascapular and Interscalene Nerve Block for Shoulder Surgery

2017 ◽  
Vol 127 (6) ◽  
pp. 998-1013 ◽  
Author(s):  
Nasir Hussain ◽  
Ghazaleh Goldar ◽  
Neli Ragina ◽  
Laura Banfield ◽  
John G. Laffey ◽  
...  
Keyword(s):  
Analgesic Effect ◽  
Recovery Room ◽  
Weighted Mean Difference ◽  
Oral Morphine ◽  
Shoulder Surgery ◽  
Morphine Consumption ◽  
Interscalene Block ◽  
Respiratory Complications ◽  
Pain Scores ◽  
The Difference

Abstract Background Interscalene block provides optimal shoulder surgery analgesia, but concerns over its associated risks have prompted the search for alternatives. Suprascapular block was recently proposed as an interscalene block alternative, but evidence of its comparative analgesic effect is conflicting. This meta-analysis compares the analgesic effect and safety of suprascapular block versus interscalene block for shoulder surgery. Methods Databases were searched for randomized trials comparing interscalene block with suprascapular block for shoulder surgery. Postoperative 24-h cumulative oral morphine consumption and the difference in the area under curve for pooled rest pain scores were designated as primary outcomes. Analgesic and safety outcomes, particularly block-related and respiratory complications, were evaluated as secondary outcomes. Results were pooled using random-effects modeling. Results Data from 16 studies (1,152 patients) were analyzed. Interscalene block and suprascapular block were not different in 24-h morphine consumption. The difference in area under the curve of pain scores for the 24-h interval favored interscalene block by 1.1 cm/h, but this difference was not clinically important. Compared with suprascapular block, interscalene block reduced postoperative pain but not opioid consumption during recovery room stay by a weighted mean difference (95% CI) of 1.5 cm (0.6 to 2.5 cm; P &lt; 0.0001). Pain scores were not different at any other time. In contrast, suprascapular block reduced the odds of block-related and respiratory complications. Conclusions This review suggests that there are no clinically meaningful analgesic differences between suprascapular block and interscalene block except for interscalene block providing better pain control during recovery room stay; however, suprascapular block has fewer side effects. These findings suggest that suprascapular block may be considered an effective and safe interscalene block alternative for shoulder surgery.

Sign in / Sign up

Export Citation Format

Share Document