Subacromial bursa block is an effective alternative to interscalene block for postoperative pain control after arthroscopic subacromial decompression: a randomized trial.
Subacromial decompression surgery is associated with significant postoperative pain. We compared interscalene block (ISB) with subacromial bursa block (SBB). Sixty consecutive patients with subacromial impingement syndrome, scheduled for arthroscopic subacromial decompression surgery, were randomized into 3 groups receiving ISB (n = 19), SBB (n = 19), or no block (n = 15 [controls]). Patients with rotator cuff tears were excluded (n = 7). The postoperative consumption of morphine, time to the first bolus of morphine, oral analgesia, pain, sickness, and sedation scores were recorded. The pain scores in the ISB and SBB groups were lower than those in the control group in the first 12 hours postoperatively. The control group consumed more morphine (mean, 32.3 mg) compared with the SBB group (mean, 21.21 mg) and ISB group (mean, 14.00 mg) (P < .001). The time to first bolus was earlier in the control group (mean, 42.1 minutes) compared with both the SBB (mean, 92.6 minutes) and ISB (mean, 119.0 minutes) groups (P < .001). The oral analgesic intake was less in the SBB and ISB groups than in the controls (P = .004). Although ISB remains the gold standard, SBB provides effective, safe, and easily administered postoperative analgesia in patients with an intact rotator cuff undergoing arthroscopic subacromial decompression.
Department of Orthopaedics, Chesterfield and North Derbyshire Royal Hospital, Chesterfield, United Kingdom.
Aamer
A
Nisar
Matthew W J
MW
Morris
Jennifer V
JV
Freeman
Jonathan M
JM
Cort
Philip R
PR
Rayner
Shantanu A
SA
Shahane
D000174:Acromion / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*