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Efficacy of direct arthroscopy-guided suprascapular nerve block after arthroscopic rotator cuff repair: a prospective randomized study

  • Shoulder
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the outcomes of arthroscopy-guided direct suprascapular nerve block performed after arthroscopic rotator cuff repair.

Methods

In the present prospective, randomized, double-blinded clinical study, 30 patients were divided into two groups: 15 patients (group I) were treated with arthroscopy-guided suprascapular nerve block using 10 mL 0.5 % ropivacaine with 1:200,000 epinephrine, and 15 patients (group II) were treated with placebo using 10 mL 0.9 % saline after arthroscopic rotator cuff repair. Patient pain levels were measured using the visual analog scale (VAS) at 1, 3, 6, 12, 18, and 24 h post-operatively. Additionally, the number of boluses and total amount of fentanyl dispensed by patient-controlled analgesia administration during the 24-h post-operative period were evaluated.

Results

VAS scores did not differ significantly between groups I and II during the 24-h post-operative period, but mean fentanyl bolus consumption was significantly less in group I compared with group II (p = 0.015).

Conclusion

Arthroscopy-guided suprascapular nerve block at the end of a rotator cuff repair was safe and less time-consuming than expected. Although this procedure did not significantly reduce the post-operative pain, the post-operative need for fentanyl boluses as analgesia was reduced significantly, and it would be beneficial if this procedure involved a sensory branch of axillary nerve block or was performed at the beginning of the arthroscopic procedure.

Level of evidence

Prospective, randomized, double-blinded clinical trial, Level I.

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References

  1. Al-Kaisy A, McGuire G, Chan VW et al (1998) Analgesic effect of interscalene block using low-dose bupivacaine for outpatient arthroscopic shoulder surgery. Reg Anesth Pain Med 23:469–473

    Article  CAS  PubMed  Google Scholar 

  2. Capdevila X, Dadure C, Bringuier S et al (2006) Effect of patient-controlled perineural analgesia on rehabilitation and pain after ambulatory orthopedic surgery: a multicenter randomized trial. Anesthesiology 105:566–573

    Article  CAS  PubMed  Google Scholar 

  3. Checcucci G, Allegra A, Bigazzi P, Gianesello L, Ceruso M, Gritti G (2008) A new technique for regional anesthesia for arthroscopic shoulder surgery based on a suprascapular nerve block and an axillary nerve block: an evaluation of the first results. Arthroscopy 24:689–696

    Article  PubMed  Google Scholar 

  4. Coghlan JA, Forbes A, McKenzie D, Bell SN, Buchbinder R (2009) Efficacy of subacromial ropivacaine infusion for rotator cuff surgery. A randomized trial. J Bone Joint Surg Am 91:1558–1567

    Article  PubMed  Google Scholar 

  5. Doss NW, Splain SH, Crimi T, Michael R, Abadir AR, Gintautas J (2001) Intra-articular morphine, ropivacaine, and morphine/ropivacaine for pain control after arthroscopy: preliminary observation. Proc West Pharmacol Soc 44:195–196

    CAS  PubMed  Google Scholar 

  6. Emery P (1989) Suprascapular nerve block for chronic shoulder pain in rheumatoid arthritis. Br Med J 299:1079–1080

    Article  CAS  Google Scholar 

  7. Eustace JA, Brophy DP, Gibney RP, Bresnihan B, FitzGerald O (1997) Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rueum Dis 56:59–63

    Article  CAS  Google Scholar 

  8. Fontana C, Di Donato A, Giacoma G et al (2009) Postoperative analgesia for arthroscopic shoulder surgery: a prospective randomized controlled study of intraarticular, subacromial injection, interscalene brachial plexus block and intraarticular plus subacromial injection efficacy. Eur J Anaesthesiol 26:689–693

    Article  PubMed  Google Scholar 

  9. Fujimuta N, Namba H, Tsunoda K et al (1995) Effects of hemidiaphragmatic paresis caused by interscalene plexus block on breathing pattern, chest wall mechanics, and arterial blood gases. Anesth Analg 81:962–966

    Google Scholar 

  10. Harmon D, Hearty C (2007) Ultrasound-guided suprascapular nerve block technique. Pain Physician 10:743–746

    PubMed  Google Scholar 

  11. Jerosch J, Saad M, Greig M, Filler T (2008) Suprascapular nerve block as a method of preemptive pain control in shoulder surgery. Knee Surg Sports Traumatol Arthrosc 16:602–607

    Article  CAS  PubMed  Google Scholar 

  12. Jeske HC, Kralinger F, Wambacher M et al (2011) A randomized study of the effectiveness of suprascapular nerve block in patient satisfaction and outcome after arthroscopic subacromial decompression. Arthroscopy 27:1323–1328

    Article  PubMed  Google Scholar 

  13. Jones A, Regan M, Hedingham J, Pattrick M, Manhire A, Doherty M (1993) Importance of placement of intra-articular injections. BMJ 307:1329–1330

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Laurila PA, Lopponen A, Kangas-Saarela T, Flinkkila T, Salomaki TE (2002) Interscalene brachial plexus block is superior to subacromial bursa block after arthroscopic shoulder surgery. Acta Anaesth Scand 46:1031–1036

    Article  CAS  PubMed  Google Scholar 

  15. Lenters TR, Davies J, Matsen FA 3rd (2007) The types and severity of complications associated with interscalene brachial plexus block anesthesia: local and national evidence. J Shoulder Elbow Surg 16:379–387

    Article  PubMed  Google Scholar 

  16. Moote C (1994) Random double-blind comparison of intra-articular bupivacaine and placebo for analgesia after outpatient shoulder arthroscopy. Anesthesiology 81:A49 (abstract)

    Google Scholar 

  17. Pippa P, Cominelli E, Marinelli C, Aito S (1990) Brachial plexus block using the posterior approach. Eur J Anaesthesiol 7:411–420

    Google Scholar 

  18. Pizzi LT, Toner R, Foley K, Thomson E, Chow W, Kim M, Couto J, Royo M, Viscusi E (2012) Relationship between potential opioid-related adverse effects and hospital length of stay in patients receiving opioids after orthopedic surgery. Pharmacotherapy 32:502–514

    Article  CAS  PubMed  Google Scholar 

  19. Ritchie ED, Tong D, Chung F, Norris M, Miniaci A, Vairavanathan SD (1997) Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality? Anesth Analg 84:1306–1312

    CAS  PubMed  Google Scholar 

  20. Schneider-Kolsky ME, Pike J, Connell DA (2004) CT-guided suprascapular nerve blocks: a pilot study. Skeletal Radiol 33:277–282

    Article  CAS  PubMed  Google Scholar 

  21. Singelyn FJ, Lhotel L, Fabre B (2004) Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg 99:589–592

    Article  PubMed  Google Scholar 

  22. Stoker DJ (1991) Intra-articular injections in capsulitis (letter). BMJ 303:123

    Google Scholar 

  23. Wassef MR (1992) Suprascapular nerve block: a new approach for the management of frozen shoulder. Anaesthesia 47:120–124

    Article  CAS  PubMed  Google Scholar 

  24. White AET, Tuite JD (1996) The accuracy and efficacy of shoulder injections in restrictive capsulitis. J Orthop Rheumatol 9:37–40

    Google Scholar 

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Authors and Affiliations

  1. Sports Center, Department of Orthopedic Surgery, School of Medicine, Dongtan Sacred Heart Hospital, Hallym University, #40, Sukwoo-dong, Hwasung, Gyungi-do, 445-170, Korea

    Yon-Sik Yoo, Jung-Taek Hwang, Do-Young Kim & Seong-Jae Jeon

  2. Anesthesiology and Pain Medicine, School of Medicine, Hallym University, Chuncheon, Korea

    Jae Jun Lee, Sung Mi Hwang & Ji Su Jang

Authors
  1. Jae Jun Lee
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  2. Yon-Sik Yoo
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  3. Jung-Taek Hwang
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  4. Do-Young Kim
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  5. Seong-Jae Jeon
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  6. Sung Mi Hwang
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  7. Ji Su Jang
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Correspondence to Yon-Sik Yoo.

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Lee, J.J., Yoo, YS., Hwang, JT. et al. Efficacy of direct arthroscopy-guided suprascapular nerve block after arthroscopic rotator cuff repair: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 23, 562–566 (2015). https://doi.org/10.1007/s00167-013-2451-x

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  • DOI: https://doi.org/10.1007/s00167-013-2451-x

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