Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial

Abstract

The aim of this study was to compare the effects of local infiltration analgesia and interscalene brachial plexus block techniques on postoperative pain control and shoulder functional scores in patients undergoing arthroscopic rotator cuff repair. Materials and methods:Sixty patients who underwent arthroscopic rotator cuff repair were prospectively included in the study. Patients were randomly divided into two groups. Group 1 was comprised of patients who had interscalene brachial plexus block, while group 2 was comprised of patients who had local infiltration analgesia. In group 1, interscalene block was applied with 20 mL 0.5% bupivacaine. In group 2, the Ranawat cocktail was used for local infiltration analgesia. Sixty milliliters of Ranawat cocktail was applied to the subacromial space and glenohumeral joint in equal amounts. Postoperative pain was assessed by the VAS score. Functional scores of the shoulder were also evaluated by Constant-Murley and UCLA scores. The time of first analgesic requirement and total analgesic consumption in the postoperative period were assessed. Results:The first analgesic requirement was significantly late in the interscalene brachial plexus block group (p = 0.000). There was no statistically significant difference between the groups in terms of total analgesic consumption (p = 0.204). In the postoperative 6th h, the VAS score was 2.43 in the interscalene brachial plexus block group, whereas 2.86 in the local infiltration analgesia group (p = 0.323). There was no statistically significant difference between the groups in terms of Constant-Murley shoulder and UCLA scores in the 3rd postoperative month (respectively, p = 0.929, p = 0.671). Besides, postoperative VAS scores and functional scores were negatively correlated (p < 0.01). Conclusion:Local infiltration analgesia is an effective alternative to interscalene brachial plexus block for postoperative pain management and total analgesic consumption in arthroscopic rotator cuff repair. However, the interscalene brachial plexus block provides a longer postoperative painless period.

The effect of general anesthesia and combined general and regional anesthesia on postoperative pain in arthroscopic rotator cuff surgery: a randomized controlled prospective study

“…1). When the methods applied to reduce postoperative pain in the literature are examined, it was found that the blocks are done in addition to general anesthesia to reduce pain in the immediate postoperative period (7,11,16,19,(22)(23)(24). Our study also found that the general anesthesia + scalene block procedure reduced postoperative pain by more than 50% compared to the other group.…”

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

“…References 2,3,[5][6][7][8][9]11,16,18,20,21,23,26,[28][29][30][31][32][33][34][35][36][37][38][40][41][42]44,45,50,51,53,[55][56][57][58]61,67. References 2,3, 5, 9, 14, 21, 26, 28, 30, 32, 34, 35, 40-42, 45, 50, 51, 53, 55, 57, 61, 63, 67. …”

“… §§ References 2, 3, 5, 9, 14, 21, 26, 28, 30, 32, 34, 35, 40 –42, 45, 50, 51, 53, 55, 57, 61, 63, 67. …”

“… ∥∥ 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. …”

“… ¶ References 2 , 3 , 5 , 6 , 11 , 14 , 28 , 32 , 33 , 35 – 38 , 40 – 42 , 44 , 57 , 58 , 61 , 63 , 67 , 68 . …”