Clin Orthop Surg.  2017 Sep;9(3):340-347. 10.4055/cios.2017.9.3.340.

Comparison of Arthroscopically Guided Suprascapular Nerve Block and Blinded Axillary Nerve Block vs. Blinded Suprascapular Nerve Block in Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial

• Ko SH
• Cho SD
• Lee CC
• Choi JK
• Kim HW
• Park SJ
• Bae MH
• Cha JR

• KMID: 2412271
• DOI: http://doi.org/10.4055/cios.2017.9.3.340

Abstract

BACKGROUND
The purpose of this study was to compare the results of arthroscopically guided suprascapular nerve block (SSNB) and blinded axillary nerve block with those of blinded SSNB in terms of postoperative pain and satisfaction within the first 48 hours after arthroscopic rotator cuff repair.
METHODS
Forty patients who underwent arthroscopic rotator cuff repair for medium-sized full thickness rotator cuff tears were included in this study. Among them, 20 patients were randomly assigned to group 1 and preemptively underwent blinded SSNB and axillary nerve block of 10 mL 0.25% ropivacaine and received arthroscopically guided SSNB with 10 mL of 0.25% ropivacaine. The other 20 patients were assigned to group 2 and received blinded SSNB with 10 mL of 0.25% ropivacaine. Visual analog scale (VAS) score for pain and patient satisfaction score were assessed 4, 8, 12, 24, 36, and 48 hours postoperatively.
RESULTS
The mean VAS score for pain was significantly lower 4, 8, 12, 24, 36, and 48 hours postoperatively in group 1 (group 1 vs. group 2; 5.2 vs. 7.4, 4.1 vs. 6.1, 3.0 vs. 5.1, 2.1 vs. 4.2, 0.9 vs. 3.9, and 1.3 vs. 3.3, respectively). The mean patient satisfaction score was significantly higher at postoperative 4, 8, 12, 24, 36, and 48 hours in group 1 (group 1 vs. group 2; 6.7 vs. 3.9, 7.4 vs. 5.1, 8.8 vs. 5.9, 9.2 vs. 6.7, 9.5 vs. 6.9, and 9.0 vs. 7.2, respectively).
CONCLUSIONS
Arthroscopically guided SSNB and blinded axillary nerve block in arthroscopic rotator cuff repair for medium-sized rotator cuff tears provided more improvement in VAS for pain and greater patient satisfaction in the first 48 postoperative hours than blinded SSNB.

Keyword

Nerve block; Rotator cuff; Suprascapular nerve block; Rotator cuff tear arthropathy

MeSH Terms

Adult
Aged
Amides/administration & dosage
Anesthetics, Local/administration & dosage
Arthroscopy/*methods
Female
Humans
Male
Middle Aged
Nerve Block/*methods
Pain Measurement
Pain, Postoperative/epidemiology/etiology
Rotator Cuff Injuries/*surgery
Amides
Anesthetics, Local

Figure

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  Fig. 1 Flowchart for patient enrollment. POD: postoperative day, SSNB: suprascapular nerve block.

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  Fig. 2 Beach chair position.

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  Fig. 3 Suprascapular nerve block (SSNB) was performed before surgical procedure in group 2 with the patient positioned in a beach chair. The X mark indicates the introducing point of SSNB, which is located in the middle between the anterolateral edge of the acromion and the superior edge of the medial scapular spine. Bony landmark was outlined with blue line.

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