Level II, Pilot Prospective Comparative Study.

Background To assess the effectiveness of a peri‐operative pain control regimen for day‐case shoulder surgery, including open and complex procedures. Methods A prospective cohort study of all patients undergoing day‐case shoulder surgery in a single hospital over a 1‐year period, using a comprehensive pain control regimen. The regimen included patient education, interscalene block, analgesics, nonsteroidal anti‐inflammatory medications and a cold compression shoulder wrap. All patients were followed up with a telephone call 24 hours after surgery to assess their pain levels, compliance and any ill effects. Results There were 187 patients in the time period, with 90.4% reporting that their pain was well controlled. Twenty‐eight patients (15%) experienced moderate and severe pain 24 hours postoperatively. These were limited to five common procedures, with arthroscopic rotator cuff repair and arthroscopic stabilization being the most common, comprising 75% of the reported painful procedures. Only four patients reported severe pain (2%). Two of these took no medication at all. Three of these four patients had 360° labral repairs and the other a massive, revision arthroscopic rotator cuff repair. Conclusion Postoperative pain after day‐case shoulder surgery can be effectively managed with a comprehensive analgesic regimen. This includes open shoulder surgery and complex arthroscopic procedures.