title: Efficacy of continuous subacromial bupivacaine infusion for pain control after arthroscopic rotator cuff repair.
abstract: OBJECTIVE
  Arthroscopic rotator cuff repair can be a painful outpatient procedure. The purpose of this study was to evaluate the efficacy of continuous subacromial bupivacaine infusion to relieve pain after arthroscopic rotator cuff repair. We hypothesized that patients receiving continuous subacromial bupivacaine infusions after arthroscopic rotator cuff repair will have less postoperative pain in the early postoperative period than placebo and control groups.
  
  
  METHODS
  Eighty-eight patients undergoing arthroscopic rotator cuff repair were randomized in a blinded fashion into 1 of 3 groups. Group 1 received no postoperative subacromial infusion catheter. Group 2 received a postoperative subacromial infusion catheter filled with saline solution. Group 3 received a postoperative subacromial infusion catheter filled with 0.5% bupivacaine without epinephrine. Infusion catheters were scheduled to infuse at 4 mL/h for 50 hours. Postoperative pain levels were assessed with visual analog scale scores hourly for the first 6 postoperative hours, every 6 hours for the next 2 days, and then every 12 hours for the next 3 days. Patients recorded daily oxycodone consumption for the first 5 postoperative days.
  
  
  RESULTS
  Immediately postoperative, the group with no catheter had significantly lower visual analog scale scores (P = .04). There were no significant differences in visual analog scale scores among the groups at any other time point. There were no differences found among the groups regarding mean daily oxycodone consumption.
  
  
  CONCLUSIONS
  The use of continuous bupivacaine subacromial infusion catheters resulted in no detectable pain reduction after arthroscopic rotator cuff repair based on visual analog scale scores and narcotic medication consumption.
authors.affiliation: Orlando Orthopaedic Center, Orlando, FL, USA. Electronic address: orlandosportsdoc@yahoo.com.
authors.forename: Randy S
authors.initials: RS
authors.lastname: Schwartzberg
authors.forename: Bryan L
authors.initials: BL
authors.lastname: Reuss
authors.forename: Randy
authors.initials: R
authors.lastname: Rust
mesh_terms: D000174:Acromion; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D001182:Arthroscopy / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: Level I; Randomized Controlled Trial; Rotator cuff tears; Treatment Study; pain catheters; rotator cuff repair; shoulder arthroscopy