ObjectiveTo assess the clinical and functional results of patients submitted to reverse arthroplasty with a minimum follow-up of one year.MethodsTwenty-two patients submitted to shoulder reverse arthroplasty by the Surgery and Shoulder Rehabilitation Group were retrospectively evaluated with pre and postoperative imaging analysis, analog pain scale, range of motion, and ASES functional score.ResultsOut of 19 (86.3%) patients with preoperative ASES classified as poor/bad, 11 (57.9%) progress to good/excellent after intervention, showing improvement of function, ranging from a mean preoperative ASES score of 22 (± 18.8) to a postoperative mean of 64.8 (± 27.7) (p = 0.031). Regarding the pain, there was an improvement in analog pain scale, presenting a preoperative mean of 7.64 (1–10) and a postoperative mean of 2.09 (0–7; p < 0.001). Regarding mobility, of 22 patients, 15 (68.2%) had preoperative pseudoparalysis and, of these, ten (66.7%) had an active anterior elevation greater than 90° after reverse arthroplasty. In turn, patients without pseudoparalysis had no significant gain in range of motion (p = 0.002). The authors observed active anterior elevation gain, with a preoperative mean of 76° (0–160°) and a postoperative mean of 111° (0–160°; p = 0.002).ConclusionDespite being a relatively new procedure in Brazil, reverse shoulder arthroplasty can be used effectively and safely in patients who were previously without treatment options such as rotator cuff arthropathy and revisions providing pain relief, improvement of function, and mobility of the upper limb.

r e v b r a s o r t o p . 2 0 1 5;5 0(1):72-76 w w w . r b o . o r g . b r Artigo Original Nível de dor no pós-operatório imediato de artrodese lombar após infiltração epidural com sulfato de morfina ଝ informações sobre o artigo Histórico do artigo: Recebido em 15 de dezembro de 2013 Aceito em 24 de fevereiro de 2014 On-line em 23 de janeiro de 2015 Palavras-chave: Morfina Analgesia epidural Dor pós-operatória Artrodese Fusão vertebral r e s u m o Objetivo: Avaliar o nível de dor em pacientes tratados com infusão epidural de sulfato de morfina em Dose única, após procedimento cirúrgico de artrodese lombar. Métodos: Foram submetidos à artrodese lombar posterolateral ou artrodese lombar intersomática por via posterior, em um, dois ou três níveis, 40 pacientes, divididos, prospectivos e randomizados em dois grupos de 20. No primeiro grupo (de estudo) foram infiltrados no espaço epidural, através da área da laminectomia, 2 mg de sulfato de morfina diluídos em 10 mL de soro fisiológico. O segundo grupo (controle) não recebeu analgesia. Os pacientes foram interrogados quanto ao nível de dor, no pré e pós-operatório, com o uso da escala visual analógica (EVA). Resultados: Verificou-se que os pacientes apresentaram uma queda significativa da dor pela EVA. A dor entre o pré e o pós-operatório diminuiu em média 4,7 pontos (p = 0,0001), o que corresponde a 53,2% (p = 0,0001). Conclusão: Aplicação de 2 mg de sulfato de morfina, em dose única epidural, demonstrou ser uma boa técnica na terapia da dor após cirurgia na coluna lombar. © 2014 Sociedade Brasileira de Ortopedia e Traumatologia. Publicado por Elsevier Editora Ltda. Todos os direitos reservados. Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate Keywords: Morphine Epidural analgesia Postoperative pain a b s t r a c t Objective: To evaluate the pain level in patients treated with epidural infusion of morphine sulfate in a single dose, after a surgical procedure to perform lumber arthrodesis.Methods: Forty patients underwent posterolateral lumbar arthrodesis or intersomatic lumbar arthrodesis via a posterior route at one, two or three levels. They were prospectively

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ObjectiveTo evaluate the pain level in patients treated with epidural infusion of morphine sulfate in a single dose, after a surgical procedure to perform lumber arthrodesis.MethodsForty patients underwent posterolateral lumbar arthrodesis or intersomatic lumbar arthrodesis via a posterior route at one, two or three levels. They were prospectively randomized into two groups of 20. In the first group (study group), 2 mg of morphine sulfate diluted in 10 mL of physiological serum was infiltrated into the epidural space, through the laminectomy area. The second group (controls) did not receive analgesia. The patients were asked about their pain levels before and after the operation, using a visual analog scale (VAS).ResultsIt was found that the patients presented a significant diminution of pain as shown by the VAS. From before to after the operation, it decreased by an average of 4.7 points (p = 0.0001), which corresponded to 53.2% (p = 0.0001).ConclusionApplication of 2 mg of morphine sulfate in a single epidural dose was shown to be a good technique for pain therapy following lumbar spinal surgery.