Long-term Effect of the Use of a Pain Pump After Arthroscopic Subacromial Decompression.
OBJECTIVE
The aim of the study was to evaluate the long-term effect of the use of a pain pump after arthroscopic subacromial decompression.


METHODS
This prospective, randomized study included 50 patients: 25 patients had a 24-hour pain pump with 0.375% ropivacaine infusion and a continuous rate of 5 mL/h in the subacromial space after arthroscopic subacromial decompression, and 25 patients did not. Rehabilitation was similar in both groups. Evaluation methods were clinical examination, radiographic evaluation, and isometric elevation strength measurements, as well as the University of California, Los Angeles and Constant shoulder scores. All the operations were done by 1 experienced orthopaedic surgeon, and all the evaluations at follow-up were done by 1 independent, blinded examiner. There were no differences between the study groups preoperatively. Of the patients, 47 (94%) were available at a minimum follow-up of 2 years (range, 24 to 32 months).


RESULTS
Concerning the duration of sick leave (P = .053) and ability to return to work (P = .321), the group differences were not statistically significant. At follow-up, the shoulder scores (University of California, Los Angeles and Constant) were significantly better than preoperatively (P < .001) in both groups, although no differences were found between the groups. The isometric elevation strengths of the operated shoulders were equally good in both groups (P = .976) as well, and no significant differences were observed between the operated shoulders and nonoperated shoulders at follow-up.


CONCLUSIONS
According to this study, the use of a pain pump after arthroscopic subacromial decompression did not have any long-term effects on the patients' recovery, return to work, or final result at the minimum 2-year follow-up. The results were significantly better at follow-up than preoperatively in both groups.


METHODS
Level II, prospective, randomized therapeutic study lacking statistical significance and narrow confidence intervals.
Järvelä
Timo
T
Orthopaedic Department, Hatanpää Hospital, Tampere, Finland. timo.jarvela@sci.fi
Järvelä
Sally
S
D000328:Adult; D000577:Amides / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006853:Hydrocodone / Q000008:administration & dosage / Q000627:therapeutic use; D015918:Infusion Pumps, Implantable; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D012783:Shoulder Dislocation / Q000601:surgery; D019534:Shoulder Impingement Syndrome / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing
D000577:Amides; D000701:Analgesics, Opioid; D006853:Hydrocodone; D000077212:Ropivacaine