Patient-controlled ropivacaine analgesia after arthroscopic subacromial decompression.
OBJECTIVE
To evaluate the efficacy of a subacromial patient-controlled analgesia (PCA) infusion of 0.2% ropivacaine versus saline for postoperative pain control following arthroscopic shoulder surgery.


METHODS
Double-blind prospective randomized study.


METHODS
A prospective, randomized double-blind study was performed on a consecutive group of 24 patients. All patients had arthroscopic subacromial decompression. Ropivacaine was chosen as the study drug due to the association of cardiac toxicity with the use of bupivacaine. The surgeon, anesthesiologist, and the operating room staff were blinded to the randomization. Immediately before surgery, the pharmacy staff randomized the type of drug infusion. Patients were asked to record their pain score using a visual analog scale (VAS) along with the amount of hydrocodone consumption for the first 2 days after surgery.


RESULTS
Nineteen patients completed the study. Ten patients received a subacromial infusion of 0.2% ropivacaine at 5 mL per hour with a bolus dose of 2 mL at a 15-minute lockout period via a microjet PCA pump (group I). Nine patients received saline in the same experimental conditions (group II). The use of a PCA ropivacaine infusion (group I) resulted in a significant reduction of postoperative pain by 34% as measured by VAS scale (P <.05), but no changes in the amount of hydrocodone consumption.


CONCLUSIONS
The use of subacromial 0.2% ropivacaine PCA infusion provided effective postoperative pain control.


METHODS
Level I.
Harvey
Gregory P
GP
Sports Medicine Service, Department of Orthopedics, USA. gharvey@oadoc.com
Chelly
Jacques E
JE
AlSamsam
Tamen
T
Coupe
Kevin
K
D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000577:Amides / Q000008:administration & dosage* / Q000627:therapeutic use; D016058:Analgesia, Patient-Controlled; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D001182:Arthroscopy; D019299:Decompression, Surgical; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D000077212:Ropivacaine; D019534:Shoulder Impingement Syndrome / Q000601:surgery*; D016896:Treatment Outcome
D000577:Amides; D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D006853:Hydrocodone; D000077212:Ropivacaine