Continuous intralesional infusion combined with interscalene block was effective for postoperative analgesia after arthroscopic shoulder surgery.
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.
Oh
Joo Han
JH
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Kim
Woo Sung
WS
Kim
Jae Yoon
JY
Gong
Hyun Sik
HS
Rhee
Ka-young
KY
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
D000779:Anesthetics, Local