title: Blind suprascapular and axillary nerve block for post-operative pain in arthroscopic rotator cuff surgery.
abstract: OBJECTIVE
  The goal of the study was to evaluate the efficacy of additional axillary nerve block (ANB) with suprascapular nerve block (SSNB) and patient-controlled anaesthesia (PCA) with no device assistance after arthroscopic rotator cuff repair. The hypothesis is that patients with intravenous (IV) PCA and the blockade of the two main nerves (SSNB + ANB) experienced lesser pain than patients with IV PCA or IV PCA + SSNB.
  
  
  METHODS
  The 114 patients undergoing arthroscopic rotator cuff repair were allocated randomly to three groups as follows: group I, intravenous PCA pumps (only PCA); group II, IV PCA + SSNB using a blind technique (PCA + SSNB); and group III, IV PCA + SSNB + ANB using a blind technique (PCA + SSNB + ANB). Pain visual analogue scale (VAS) scores were evaluated at 1, 6, 12, 24, 36, and 48 post-operative hours. Furthermore, the degree of pain was compared according to cuff tear size.
  
  
  RESULTS
  The pain VAS score of group III was lower than that of the other two groups and was significantly lower at post-operative hours 1, 6, and 12. In addition, the larger cuff tear tended to be indicative of greater pain. However, all groups experienced rebound pain.
  
  
  CONCLUSIONS
  PCA + SSNB + ANB using a blind technique is a better pain control method than PCA + SSNB and only PCA during the initial 12 post-operative hours. PCA + SSNB + ANB is a cost-effective, time-saving, and easily performed method for post-operative pain control as an axis of multimodal pain control strategy.
  
  
  METHODS
  II.
authors.affiliation: NEON Orthopaedic Center, Seoul, South Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. drbang@paik.ac.kr.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Bang
authors.affiliation: Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Oh
mesh_terms: D000368:Aged; D016058:Analgesia, Patient-Controlled; D001182:Arthroscopy; D001365:Axilla; D001917:Brachial Plexus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Axillary nerve block; Patient-controlled analgesia; Rotator cuff repair; Shoulder arthroscopic surgery; Suprascapular nerve block