Analgesia requirements after interscalene block for shoulder arthroscopy: the 5 days following surgery.
BACKGROUND
Excellent initial post-operative analgesia for patients undergoing arthroscopic shoulder surgery can be provided with a single-shot interscalene brachial plexus block. However there have been concerns that when the block wears off, patients may experience pain and this may occur at home. Some investigators have advocated the use of continuous ambulatory local anaesthetic infusions following hospital discharge. We prospectively studied pain scores, analgesic requirements and satisfaction of patients at home in the first 5 days following arthroscopic shoulder surgery to see whether continuous infusion would be of benefit.


RESULTS
Fifteen percent of patients experienced severe pain at some time over the first 3 days, and this percentage decreased to 7% by day 5. However 97% of our patients were satisfied with their post-operative oral analgesia management and less than 5% contacted their GP for further analgesia issues. Over 80% of our patients required only simple analgesics following hospital discharge.


CONCLUSIONS
Post-operative continuous ambulatory local anaesthetic infusions may not be justified following this intermediate magnitude of surgery.
Trompeter
Alex
A
Department of Orthopaedic Surgery, Worthing & Southlands NHS Trust, Lyndhurst Road, Worthing, UK. alex_trompeter@hotmail.com
Camilleri
Giancarlo
G
Narang
Kush
K
Hauf
Werner
W
Venn
Richard
R
D000698:Analgesia / Q000592:standards*; D000700:Analgesics / Q000008:administration & dosage*; D001182:Arthroscopy / Q000379:methods*; D001917:Brachial Plexus / Q000187:drug effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011446:Prospective Studies; D012785:Shoulder Joint / Q000601:surgery*
D000700:Analgesics