Continuous suprascapular nerve block compared with single-shot interscalene brachial plexus block for pain control after arthroscopic rotator cuff repair

Choi, Hoon; Roh, Kyungmoon; Joo, Mina; Hong, Sang Hyun

doi:10.6061/clinics/2020/e2026

Cited by 6 publications

(8 citation statements)

References 51 publications

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“…Regional nerve block using local anesthetics has been attempted via different routes, such as the interscalene, supraclavicular, and suprascapular routes and along the brachial plexus, and their effectiveness has been compared in numerous studies [ 19 , 20 , 21 , 22 ]. In addition to the nerve block site, there are various opinions on whether a single shot or continuous injection using a catheter is superior [ 2 , 23 , 24 , 25 ]. Continuous infusion using a catheter is effective for relieving pain, but it can prolong the length of hospital stay, induce a greater number of side effects, and must be monitored cautiously [ 25 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to SSIB, rebound hyperalgesia does not occur in IICA due to the continuous nature of the infusion [ 1 , 2 , 3 ]. However, problems associated with IICA include the difficulty in relieving pain during very early periods after ARCR, the discomfort of catheter itself, neurological problems, and the inconvenience of managing the patient-controlled analgesia (PCA) device.…”

Section: Introductionmentioning

confidence: 99%

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Is There a Difference between Perineural Dexamethasone with Single-Shot Interscalene Block (SSIB) and Interscalene Indwelling Catheter Analgesia (IICA) for Early Pain after Arthroscopic Rotator Cuff Repair? A Pilot Study

Kim

Park

Koh

2022

JCM

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Interscalene block is applied to control acute postoperative pain after arthroscopic rotator cuff repair (ARCR), typically with single-shot interscalene block (SSIB) or continuous interscalene indwelling catheter analgesia (IICA), and dexamethasone (Dex) for extending the analgesic effect. This study investigated whether perineural Dex can extend the postoperative analgesic effect of SSIB to match that of IICA. A total of 130 patients were recruited and divided into two groups (Group D, SSIB with perineural Dex, n = 94; Group C, IICA, n = 36). The surgical and anesthetic processes were identical except for the method of nerve block. Pain was measured by a visual analog scale (VAS) at 6, 12, 24, and 48 h after ARCR. The number of each and the total analgesics used and adverse effects were compared. The duration of ARCR was longer in group D. The VAS score was higher in group C 6 h after ARCR, but there was no difference at other time points. More postoperative analgesics were administered to group C, and there was no difference in the number of adverse effects. In conclusion, combining perineural Dex with SSIB can reduce rebound hyperalgesia after 6 h and extend the duration of the analgesic effect to that of IICA. Therefore, IICA could be substituted with SSIB and Dex between at 6 and 48 h after ARCR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is There a Difference between Perineural Dexamethasone with Single-Shot Interscalene Block (SSIB) and Interscalene Indwelling Catheter Analgesia (IICA) for Early Pain after Arthroscopic Rotator Cuff Repair? A Pilot Study

Kim

Park

Koh

2022

JCM

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“…In terms of operative techniques, rotator cuff repair was used in 23 studies { ; rotator cuff repair and acromioplasty in 9 studies [7][8][9]18,21,26,30,31,53 ; rotator cuff repair and distal clavicle resection in 2 studies 16,23 ; rotator cuff repair and biceps tenotomy or tenodesis in 2 studies 20,34 ; rotator cuff repair, biceps tenodesis or tenotomy, and distal clavicle resection in 2 studies 50,56 ; rotator cuff repair, acromioplasty, and biceps tenotomy or tenodesis in 3 studies 29,45,51 ; and rotator cuff repair, distal clavicle resection, biceps tenotomy or tenodesis, and acromioplasty in 1 study. 55 A full-thickness tear was evaluated in 14 studies # and partialand full-thickness tears in 12 studies, ** but the tear size was not mentioned in the other 16 studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“… ∥∥ References 2, 3, 5 –9, 11, 14, 16, 20, 21, 23, 26, 28, 29, 31 –38, 40 –42, 44, 45, 50, 53, 55 –58, 61, 63, 67, 68. …”

mentioning

confidence: 99%

Comparison of Analgesia Treatment Methods After Arthroscopic Rotator Cuff Repair: A Network Meta-analysis of 42 Randomized Controlled Trials

Liu

Zhang

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: The optimal method for postoperative analgesia after arthroscopic rotator cuff repair (ARCR) is still unclear. Purpose: To compare the efficacy of postoperative analgesic methods after ARCR through network meta-analysis of randomized controlled trials and prospective controlled trials. Study Design: Systematic review; Level of evidence, 2. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, Embase, and Web of Science from inception until April 12, 2022, for randomized controlled trials and prospective controlled trials evaluating neuraxial analgesia, peripheral nerve block, periarticular local anesthetic infiltration, intravenous patient-controlled analgesia, oral analgesia, or any combination of these methods for pain management after ARCR. Outcomes included pain scores at rest, morphine consumption, and complications (nausea and vomiting). Study quality was assessed using the Cochrane risk-of-bias tool. Network meta-analysis was used to assess the relative efficacy of the methods for postoperative analgesia. The best choice for postoperative analgesia was defined as the one with significant differences in pain scores and morphine consumption compared with placebo, with no significant difference in complications, during the initial 48 hours postoperatively. Results: Included were 42 studies with 3110 patients. Only suprascapular nerve block (SSNB) was significantly superior to placebo in pain scores (mean difference [MD], –0.93 [95% CI, –1.31 to –0.54] at 6 hours; MD, –2.34 [95% CI, –3.49 to –1.19] at 12 hours) and morphine consumption (MD, –17.70 [95% CI, –32.98 to –2.42] at 24 hours) ( P < .05 for all), with no difference in complications (odds ratio, 0.96 [95% CI, 0.21 to 4.32]; P > .05). Pain scores were significantly lower with interscalene nerve block compared with SSNB (MD, –0.69 [95% CI, –1.17 to –0.20] at 6 hours; MD, –1.44 [95% CI, –2.21 to –0.67] at 12 hours) and with SSNB + axillary nerve block compared with SSNB (MD, –3.09 [95% CI, –4.18 to –1.99] at 6 hours; MD, –0.87 [95% CI, –1.71 to –0.03] at 12 hours) ( P < .05 for all). Conclusion: Based on the current evidence, most analgesic methods lowered pain and morphine consumption compared with placebo. There were significant differences in pain scores between interscalene nerve block and SSNB during the first 12 hours postoperatively, and adding axillary nerve block to SSNB enhanced the analgesic effect.

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“…The recovery period after arthroscopic shoulder surgery invariably involves a certain degree of pain for patients [1][2][3][4]. Postoperative pain experienced by patients who have undergone arthroscopic shoulder surgery was found to be related to the presence of a brachial plexus block using the interscapular approach (anesthesia block) during surgical anesthesia [5][6][7][8][9][10][11][12][13][14][15][16][17]. Postoperative recovery varies greatly for each person and is also related to the use of pain reduction techniques, prompt initiation of rehabilitation, promotion of blood circulation, prevention of muscle contracture, and restoration of the range of motion in the shoulder joint [3,[18][19][20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Investigation of cryotherapy for pain relief after arthroscopic shoulder surgery

et al. 2022

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Background Recently, cryotherapy has become a common practice for postoperative pain management. The current accepted practice in Japan is the use of cryotherapy at 5 °C after arthroscopic shoulder surgery. However, this therapy has been reported to be highly intense because the sustained low temperature causes discomfort for patients. The optimum temperature and duration of cooling required for comfortable and effective cryotherapy after arthroscopic shoulder surgery were investigated. Methods Because pain levels might differ depending on the condition, we selected 52 patients with rotator cuff injuries, which were the most common disorders indicated for arthroscopic shoulder surgery. Patients were treated with cryotherapy at 5 °C or 10 °C for 16 h or 24 h. The pain level was determined using the visual analogue scale, and deep shoulder joint temperatures were recorded at different time points for analysis. Results Pain after arthroscopic shoulder surgery was found to be related to the presence of a brachial plexus block using the interscalene approach during surgical anesthesia. To obtain effective analgesia with cryotherapy, the cooling temperature and duration of cryotherapy had to be changed based on the presence or absence of the brachial plexus block. Patients who received brachial plexus blocks had the lowest recorded pain scores after receiving cryotherapy at 5 °C for 24 h after surgery. Patients who did not receive the block had the lowest recorded pain scores when receiving cryotherapy at either 5 °C for 16 h or 10 °C for 24 h. Conclusions Using universal cryotherapy intensity and duration settings regardless of the use of other interventions is likely to unintentionally increase postoperative pain levels. This study revealed that cryotherapy at 5 °C for 24 h was optimal for patients who received an anesthesia block and at 5 °C for 16 h or at 10 °C for 24 h for those who did not receive the anesthesia block. These results can be used as a reference for setting the temperature and duration of cryotherapy after arthroscopic shoulder surgery.

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Continuous suprascapular nerve block compared with single-shot interscalene brachial plexus block for pain control after arthroscopic rotator cuff repair

Cited by 6 publications

References 51 publications

Is There a Difference between Perineural Dexamethasone with Single-Shot Interscalene Block (SSIB) and Interscalene Indwelling Catheter Analgesia (IICA) for Early Pain after Arthroscopic Rotator Cuff Repair? A Pilot Study

Is There a Difference between Perineural Dexamethasone with Single-Shot Interscalene Block (SSIB) and Interscalene Indwelling Catheter Analgesia (IICA) for Early Pain after Arthroscopic Rotator Cuff Repair? A Pilot Study

Comparison of Analgesia Treatment Methods After Arthroscopic Rotator Cuff Repair: A Network Meta-analysis of 42 Randomized Controlled Trials

Investigation of cryotherapy for pain relief after arthroscopic shoulder surgery

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