Efficacy of axillary nerve block in elbow arthroscopic surgery: a randomized trial.
BACKGROUND
The purpose of this study was to evaluate postoperative pain levels after arthroscopic elbow surgery under general anesthesia and to determine whether an axillary nerve block provides additional pain management benefits compared with a portal site injection of local anesthetic.


METHODS
Thirty-six patients undergoing arthroscopic elbow surgery under general anesthesia were randomized to either a study group receiving axillary nerve block (Ax group) or a control group receiving portal site injections of local anesthetic (Lo group). During the first 48 hours after surgery, pain visual analog scale (VAS) scores (0-100), total amount of oral analgesics required, and patient satisfaction were assessed.


RESULTS
Among all 36 patients, mean pain VAS scores at rest were 37, 18, and 9 for the first 12-hour period and at 24 and 48 hours after surgery, respectively. The mean pain VAS scores during physiotherapy were 47 and 33 at 24 and 48 hours postoperatively, respectively. No intergroup differences were observed between the Ax and Lo groups at any time point after surgery (P value range, .41 to .87). The mean number of loxoprofen tablets required during the 48-hour study period was 5.1 in the Ax group and 4.5 in the Lo group (P = .90). The Ax and Lo groups had mean overall patient satisfaction scores of 91 and 91, respectively (P = .98).


CONCLUSIONS
Postoperative pain levels after arthroscopic elbow surgery could be well managed with oral analgesics and local anesthetic. An axillary nerve block was not found to provide any postoperative pain control benefits.
Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan. Electronic address: twada@sapmed.ac.jp.
Takuro
T
Wada
Department of Anesthesiology, Tohoku University, Sendai, Japan.
Masanori
M
Yamauchi
Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
Gosuke
G
Oki
Department of Public Health, Sapporo Medical University, Sapporo, Japan.
Tomoko
T
Sonoda
Department of Anesthesiology, Sapporo Medical University, Sapporo, Japan.
Michiaki
M
Yamakage
Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
Toshihiko
T
Yamashita
D000700:Analgesics / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001182:Arthroscopy / Q000379:methods*; D001365:Axilla; D004550:Elbow / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000145:classification* / Q000517:prevention & control; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010666:Phenylpropionates / Q000008:administration & dosage; D011446:Prospective Studies; D016896:Treatment Outcome
D000700:Analgesics; D000779:Anesthetics, Local; D010666:Phenylpropionates; C040656:loxoprofen
Elbow arthroscopy; axillary nerve block; general anesthesia; local anesthetic; oral analgesics; postoperative pain