International Orthopaedics

, Volume 43, Issue 6, pp 1435–1441 | Cite as

Post-operative pain control following arthroscopic rotator cuff repair: peri-articular injection versus interscalene brachial plexus block

  • Masayoshi Saito
  • Sachiyuki Tsukada
  • Nobuko Fujita
  • Mahbubur Rahman
  • Wataru Morita
  • Nobuto Kitamura
  • Atsushi TasakiEmail author
Original Paper



To compare post-operative pain relief with peri-articular injection (PI) versus interscalene brachial plexus block (IBPB) after arthroscopic rotator cuff repair (ARCR) surgery.


We retrospectively reviewed 121 consecutive patients undergoing ARCR surgery divided into two groups: the PI group and the IBPB group. We compared complications and self-reported pain score measured using a Numerical Rating Scale (NRS) during the initial 24 hours after surgery.


The NRS scores recorded in the recovery room (0), 0.5, and four hours post-operatively were higher in the PI group (n = 38) than the IBPB group (n = 52) (2.1 vs. 0.8, p = 0.014; 1.4 vs. 0.5, p = 0.0069; and 1.3 vs. 0.5, p = 0.012, respectively). However, the NRS scores recorded at 16, 20, and 24 hours post-operatively were lower in the PI group than in the IBPB group (1.4 vs. 3.1, p < 0.0001; 1.4 vs. 3.2, p < 0.0001; and 1.7 vs. 3.2, p = 0.00046, respectively). The incidences of post-operative nausea and temporary numbness in the upper arm were significantly lower in the PI group than in the IBPB group (7.9% vs. 33%, p = 0.0052; and 13% vs. 85%, p < 0.0001, respectively).


Although IBPB provided superior pain control during the initial few hours after ARCR surgery, PI was superior from 16 to 24 hours post-operatively. The rates of side effects, such as nausea and temporary arm numbness, were also lower in the PI group than in the IBPB group.


Shoulder Pain management Peri-articular injection Interscalene brachial plexus block Arthroscopic rotator cuff repair 


Compliance with ethical standards

The study protocol and publication plan were approved by our institutional ethics committee.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Masayoshi Saito
    • 1
  • Sachiyuki Tsukada
    • 1
  • Nobuko Fujita
    • 2
  • Mahbubur Rahman
    • 3
  • Wataru Morita
    • 4
  • Nobuto Kitamura
    • 1
  • Atsushi Tasaki
    • 1
    Email author
  1. 1.Department of Orthopedics SurgerySt. Luke’s International HospitalTokyoJapan
  2. 2.Department of AnesthesiaSt. Luke’s International HospitalTokyoJapan
  3. 3.Center for Clinical EpidemiologySt. Luke’s International UniversityTokyoJapan
  4. 4.Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK

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