title: Continuous intralesional infusion combined with interscalene block was effective for postoperative analgesia after arthroscopic shoulder surgery.
abstract: The purpose of this study was to compare the efficacy of postoperative pain control by intravenous patient-controlled analgesia (IV) and by continuous intralesional infusion of a local anesthetic (IL) with or without an interscalene block (ISB) after arthroscopic shoulder surgery. We allocated 84 patients to 4 groups according to analgesic method: IV, ISB-IV, IL, and ISB-IL. Postoperative pain, side effects, and supplementary analgesics were recorded at 1 hour and then every 8 hours for 48 hours. The interscalene block (groups ISB-IV and ISB-IL) was found to be effective at relieving pain and at reducing supplementary analgesic amounts at 1 and 8 hours postoperatively (P < .05). Patients in group ISB-IL had less pain at 16 and 48 hours postoperatively than those in the other groups (P < .05). Continuous intralesional infusion (groups IL and ISB-IL) was superior in reducing analgesic-related side effects (P < .05). This study suggests that a combination of an interscalene block and continuous intralesional infusion of a local anesthetic is an effective and safe method of postoperative pain control after arthroscopic shoulder surgery.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Oh
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Kim
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Kim
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.forename: Ka-young
authors.initials: KY
authors.lastname: Rhee
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local