title: Suprascapular Nerve Block Versus Interscalene Block as Analgesia After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Noninferiority Trial.
abstract: To compare the efficacy of suprascapular nerve block (SSB) and interscalene block (ISB) as postoperative analgesia within the first 24 hours after arthroscopic supraspinatus and/or infraspinatus tendon repair.
  
  
  
  A single-blind, randomized controlled study was performed between 2013 and 2014. The inclusion criteria were arthroscopic supraspinatus and/or infraspinatus tendon repair confirmed intraoperatively, with or without associated procedures, and informed consent. The exclusion criteria were a previously operated shoulder, repair of the subscapularis tendon, and an allergy to local anesthetics. ISB was performed under ultrasound guidance by an anesthesiologist, whereas SSB was performed based on specific anatomic landmarks by a surgeon. The primary evaluation criterion was mean shoulder pain score during the first postoperative 24 hours assessed on a visual analog scale by the patient. The secondary criteria were complications of locoregional anesthesia, the use of analgesics in the recovery room (the first 2 hours) until postoperative day 7, and pain (visual analog scale) during the first week. Forty-four patients were needed for this noninferiority study. An institutional review board approved the study.
  
  
  
  Seventy-four patients were randomized, and 59 met the intraoperative inclusion criteria. Six patients were excluded (1 for pneumothorax after ISB, 1 for unsuccessful SSB, and 4 for incomplete questionnaires). None of the patients were lost to follow-up. There was no significant difference between the SSB and ISB groups in mean pain score for the first 24 hours (P = .92) or the first 7 days (P = .05). However, there was significantly less pain in the ISB group in the recovery room (P = .01). Consumption of analgesics was comparable between the groups, but the SSB group took significantly more morphine in the recovery room.
  
  
  
  In this prospective, randomized controlled study, SSB was as effective as ISB for mean pain control within the first 24 hours but ISB was more effective in relieving pain in the recovery room after arthroscopic supraspinatus and/or infraspinatus tendon repair.
  
  
  
  Level I, therapeutic, randomized controlled study.
authors.affiliation: Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France. Electronic address: asuka.desroches@gmail.com.
authors.forename: Asuka
authors.initials: A
authors.lastname: Desroches
authors.affiliation: Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Klouche
authors.affiliation: Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Schlur
authors.affiliation: Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Waitzenegger
authors.affiliation: Hôpitaux Universitaires Paris Ile de France Ouest, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR des Sciences de la Santé, Versailles, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000577:Amides / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D001182:Arthroscopy; D065527:Brachial Plexus Block / Q000379:methods*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D010149:Postoperative Pain / Q000517:prevention & control*; D000077212:Ropivacaine; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D016037:Single-Blind Method; D064232:Visual Analog Scale
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D009294:Narcotics; D009020:Morphine; D000077212:Ropivacaine