Clin Orthop Surg.  2009 Mar;1(1):48-53. 10.4055/cios.2009.1.1.48.

Comparison of Analgesic Efficacy between Single Interscalene Block Combined with a Continuous Intra-bursal Infusion of Ropivacaine and Continuous Interscalene Block after Arthroscopic Rotator Cuff Repair

• Oh JH
• Rhee KY
• Kim SH
• Lee PB
• Lee JW
• Lee SJ

• KMID: 1127914
• DOI: http://doi.org/10.4055/cios.2009.1.1.48

Abstract

BACKGROUND: This study evaluated the effectiveness of a continuous interscalene block (CISB) by comparing it with that of a single interscalene block combined with a continuous intra-bursal infusion of ropivacaine (ISB-IB) after arthroscopic rotator cuff repair.
METHODS
Patients who had undergone CISB (CISB group; n = 25) were compared with those who had undergone ISB-IB (ISB-IB group; n = 25) for more than 48 hours after surgery. The visual analog scale (VAS) for pain, motor and/or sensory deficit, supplementary analgesics and adverse effects were recorded.
RESULTS
There were no significant differences between the postoperative VAS of the CISB and ISB-IB groups, except at 1 hour after surgery. Their supplementary analgesics of the two groups were similar. Transient motor weakness (52%) and sensory disturbance (40%) of the affected arm were observed in patients in the CISB group. The catheters came out accidentally in 22% of the CISB group but in only 4% of the ISB-IB group.
CONCLUSIONS
ISB-IB provides similar analgesia to CISB. However, the ISB-IB group had a lower incidence of neurological deficits and better catheter retention.

Keyword

Shoulder; Rotator cuff tear; Postoperative pain control; Continuous interscalene block; Single interscalene block with intra-bursal infusion; Arthroscopic rotator cuff repair

MeSH Terms

Adult
Aged
Amides/*administration & dosage
Analgesia/*methods
Anesthetics, Local/*administration & dosage
Arthroscopy
Bursa, Synovial
Case-Control Studies
Female
Humans
Infusions, Intralesional
Male
Middle Aged
*Nerve Block
Pain Measurement
Pain, Postoperative/*prevention & control
Prospective Studies
Rotator Cuff/*surgery
Shoulder Joint/surgery

Figure

• 

  Fig. 1 Postoperative pain VAS showing a similar level of pain in the CISB and ISB-IB group, except at 1 hour after surgery. *At this time, the pain VAS was higher in the CISB group than in the ISB-IB group (p < 0.05).

• 

  Fig. 2 The additional analgesic requirements were similar in both groups.

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