title: Analgesic effectiveness of nerve block in shoulder arthroscopy: comparison between interscalene, suprascapular and axillary nerve blocks.
abstract: OBJECTIVE
  Postoperative pain in arthroscopic shoulder surgery cannot be easily controlled with analgesics and nerve blocks. This study shows the analgesic effect of interscalene block (ISB) and suprascapular nerve block and axillary nerve block (SSNB + ANB) in patients under patient controlled analgesia (PCA).
  
  
  METHODS
  Sixty-one patients (26 men and 35 women) who underwent arthroscopic rotator cuff repair were selected and allocated non-randomly to one of three groups: PCA only-group, PCA with ISB-group and PCA with SSNB + ANB-group. Visual analogue scale (VAS) score, degree of satisfaction, PCA usage and incidence of nausea and vomiting were evaluated at the recovery room, 8, 16 and 24 postoperative hours.
  
  
  RESULTS
  The VAS score of the PCA only-group was highest at the recovery room. The VAS score of the PCA with ISB-group was the lowest, however, with large fluctuations over time. Although the VAS score of the PCA with SSNB + ANB-group was higher than that of the PCA with ISB-group, it was steadily lower than the PCA-only group, without any fluctuations. The degree of satisfaction of the PCA with ISB-group was highest at the recovery room. The number of times the PCA was used at the 8-h postoperative evaluation was largest in the PCA only-group.
  
  
  CONCLUSIONS
  The initial 24 h after surgery plays a key role in controlling pain after arthroscopic shoulder surgery. PCA with SSNB + ANB is a better anaesthetic choice than PCA with ISB or PCA only during the initial 24 h of the postoperative period.
  
  
  METHODS
  Clinical study, Level II.
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Daejeon Metropolitan City, South Korea.
authors.forename: Sang Mook
authors.initials: SM
authors.lastname: Lee
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Park
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Nam
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Han
authors.forename: Kwang-Jin
authors.initials: KJ
authors.lastname: Lee
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Kwon
authors.forename: Jong-Hun
authors.initials: JH
authors.lastname: Ji
authors.forename: Syung-Kyun
authors.initials: SK
authors.lastname: Choi
authors.forename: Jang-Su
authors.initials: JS
authors.lastname: Park
mesh_terms: D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000601:surgery*; D011446:Prospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome