Analgesic effect of periarticular cocktail injection after rotator cuff repair surgery
10.3760/cma.j.cn121113-20230926-00205
- VernacularTitle:关节周围鸡尾酒注射对关节镜下肩袖修复术后的镇痛作用
- Author:
Shaobo LI
1
;
Yijun ZHANG
;
Xiaotian MA
;
Yudong GAN
Author Information
1. 山东大学齐鲁医院（青岛）运动医学科，青岛 266035
- Keywords:
Shoulder;
Rotator cuff injuries;
Arthroscopy;
Pain, postoperative;
Cocktail injection
- From:
Chinese Journal of Orthopaedics
2024;44(9):609-615
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of periarticular cocktail injection analgesia after arthroscopic rotator cuff repair surgery.Methods:From June 2020 to May 2021, 120 patients with rotator cuff tears were treated at Shandong University Qilu Hospital (Qingdao) with arthroscopic rotator cuff repair surgery. The cohort included 45 males and 75 females, aged 61.35±5.75 years (range 57-67 years), with 58 cases involving the left shoulder joint and 62 cases involving the right shoulder joint. Patients were randomly divided into a cocktail group (receiving periarticular injections of ropivacaine, morphine, adrenaline, and compound betamethasone) and an analgesic pump group (using an analgesic pump). Standardized protocols were used for perioperative and postoperative analgesia. The visual analog scale (VAS) of pain and shoulder joint range of motion were recorded on the day of surgery, the first and second postoperative days, the day of discharge, and at follow-up at 2 and 6 weeks. The postoperative demand for temporary analgesics (celecoxib), as well as adverse reactions to cocktail injections and analgesic pump applications were also recorded.Results:There were no statistically significant differences in age, gender, surgical time, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, preoperative VAS score, surgical time, postoperative hospital stay, rotator cuff tear area, and intraoperative anchor number between the two groups of patients ( P>0.05). Patients who received periarticular cocktail injections performed better in terms of postoperative VAS scores and functional recovery. Compared with the analgesic pump group, the temporary use of analgesics in the cocktail group was significantly reduced at 6, 12, and 24 hours after surgery. After 12 hours of surgery, the cocktail group received 3(3, 4) points and the analgesic pump group received 5(5, 6) points, with statistically significant differences ( Z=143.004, P=0.003); 18 hours after surgery, the VAS score in the cocktail group showed a rebound, rising to 4(3, 4) points, but still lower than 5(4, 5) points in the analgesic pump group. There was no significant difference in VAS scores between the cocktail group and the analgesic pump group at 24-48 hours after surgery ( P>0.05). The use of cocktail injections was associated with lower VAS scores at 12 hours post-surgery ( OR=4.125; 95% CI: 2.672, 4.328; P=0.015). There is no correlation between age, BM, ASA, pre-operative VAS, surgical time, rotator cuff tear size, number of anchor bolts used, and postoperative VAS score at 12 hours. Multivariate regression analysis of postoperative 24-hour VAS scores showed that no factors were associated with postoperative 24-hour VAS scores. Conclusion:Periarticular cocktail injection can significantly reduce the need for postoperative pain relief and improve patient satisfaction, without posing significant risks after arthroscopic rotator cuff repair surgery.
