Patient-controlled analgesia after arthroscopic rotator cuff repair: subacromial catheter versus intravenous injection.
BACKGROUND
No study has compared pain control results between patient-controlled subacromial infusion and intravenous injection after arthroscopic shoulder surgery.


OBJECTIVE
Subacromial infusion of analgesics are more effective in pain alleviation than intravenous injection.


METHODS
Randomized controlled clinical trial; Level of evidence, 2.


METHODS
The authors prospectively analyzed 40 cases of arthroscopic rotator cuff repair that received patient-controlled analgesia. They divided the 40 cases into 2 groups: subacromial infusion group with 0.5% bupivacaine (group 1, 20 cases) and intravenous injection group with fentanyl and ketorolac tromethamine (group 2, 20 cases). The visual analog scale was used to record the patient's level of pain every 12 hours until postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia.


RESULTS
The mean preoperative visual analog scale score during motions was 6.8 in group 1 and 5.8 in group 2. The immediate postoperative visual analog scale score was 7.6 and 7.4, respectively, for each group. At postoperative time periods, most of the scores of subacromial infusion at rest and during motions were lower than those of intravenous injection, but significant differences were not found between groups 1 and 2.


CONCLUSIONS
Patient-controlled analgesia after arthroscopic rotator cuff repair showed that both subacromial infusion of bupivacaine and intravenous injection of fentanyl and ketorolac tromethamine were equally effective and clinically equivalent pain control methods.
Cho
Nam Su
NS
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
Ha
Jeong Han
JH
Rhee
Yong Girl
YG
D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D020910:Ketorolac / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005283:Fentanyl; D002045:Bupivacaine; D020910:Ketorolac