title: A randomised controlled trial comparing continuous supraclavicular and interscalene brachial plexus blockade for open rotator cuff surgery.
abstract: Continuous interscalene block is an approved modality for postoperative pain control, but it may cause hemidiaphragmatic paresis. In this study we aimed to determine whether continuous supraclavicular block would provide postoperative analgesia comparable to that of continuous interscalene block and reduce the incidence of hemidiaphragmatic paresis. Patients scheduled for open rotator cuff repair were randomly allocated to receive continuous interscalene (n = 38) or supraclavicular block (n = 37). Both participants and assessing clinicians were blinded to the group allocation. The primary endpoint was the mean pain intensity 24 h after the surgery. Postoperative mean (SD) pain scores at 24 h were similar in the supraclavicular and interscalene groups (2.57 (1.71) vs 2.84 (1.75) respectively; p = 0.478). The incidence of complete or partial hemidiaphragmatic paresis was lower in the supraclavicular group at 1 h after admission to the postanaesthetic care unit and 24 h after the surgery [25 (68%) vs 38 (100%); p = 0.001 and 14 (38%) vs 27 (71%) respectively; p = 0.008]. Continuous supraclavicular block provided comparable analgesia compared with interscalene block with a reduced incidence of complete or partial hemidiaphragmatic paresis for 24 h following surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: W U
authors.initials: WU
authors.lastname: Koh
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: W J
authors.initials: WJ
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Ro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065527:Brachial Plexus Block / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery*
keywords: interscalene block: side effects; supraclavicular block: side effects; upper extremity: regional management