A Comparison of Three Methods for Postoperative Pain Control in Patients Undergoing Arthroscopic Shoulder Surgery.
- Author:
Sun Kyung PARK
1
;
Yun Suk CHOI
;
Sung Wook CHOI
;
Sung Wook SONG
Author Information
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords: Analgesia; Arthroscopy; Epidural anesthesia; Interscalene block; Intraarticular injection; Pain
- MeSH: Analgesia; Anesthesia, Epidural; Anesthesia, General; Arthroscopy; Brachial Plexus; Equidae; Humans; Injections, Intra-Articular; Morphine; Nerve Block; Pain, Postoperative*; Prospective Studies; Shoulder*
- From:The Korean Journal of Pain 2015;28(1):45-51
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Arthroscopic shoulder operations (ASS) are often associated with severe postoperative pain. Nerve blocks have been studied for pain in shoulder surgeries. Interscalene brachial plexus blocks (ISB) and an intra-articular injection (IA) have been reported in many studies. The aim of the present study is to evaluate the effect of ISB, a continuous cervical epidural block (CCE) and IA as a means of postoperative pain control and to study the influence of these procedures on postoperative analgesic consumption and after ASS. METHODS: Fifty seven patients who underwent ASS under general anesthesia were randomly assigned to one of three groups: the ISB group (n = 19), the CCE group (n = 19), and the IA group (n = 19). Patients in each group were evaluated on a postoperative numerical rating scale (NRS), their rescue opioid dosage (ROD), and side effects. RESULTS: Postoperative NRSs were found to be higher in the IA group than in the ISB and CCE groups both at rest and on movement. The ROD were 1.6 +/- 2.3, 3.0 +/- 4.9 and 7.1 +/- 7.9 mg morphine equivalent dose in groups CCE, ISB, and IA groups (P = 0.001), respectively, and statistically significant differences were noted between the CCE and IA groups (P = 0.01) but not in between the ISB and CCE groups. CONCLUSIONS: This prospective, randomized study demonstrated that ISB is as effective analgesic technique as a CCE for postoperative pain control in patients undergoing ASS.
