Analgesic efficacy of two interscalene blocks and one cervical epidural block in arthroscopic rotator cuff repair

Abstract

Randomized controlled trials, Therapeutic study, Level I.

Acute postoperative pain after arthroscopic rotator cuff surgery: A review of methods of pain assessment

“…To describe higher pain levels, the scales used 14 different anchors in total ( Figure 2 ) with “worst pain imaginable” [ 11 , 12 , 15 , 26 , 36 , 38 , 43 , 48 , 51 , 54 ] being the preferred anchor. The second most frequent anchor was “worst pain” [ 10 , 28 , 33 , 34 ] and then successively “most severe pain imaginable” [ 19 , 20 , 37 ], “severe pain” [ 18 , 32 , 46 ], and “worst possible pain” [ 29 , 41 , 47 ]. Twelve studies did not report the used anchors [ 13 , 16 , 17 , 27 , 31 , 35 , 40 , 49 , 50 , 55 – 57 ].…”

“…Pain ratings were specified to be at rest or during activity in 11 studies [ 10 , 13 , 16 , 23 , 26 – 28 , 32 , 44 , 55 , 58 ], of which 3 studies [ 10 , 16 , 26 ] specified pain to be exclusively measured at rest. Eight out of the 11 studies described pain during activity and the definitions were: movement during cough and mobilization [ 27 ], motion attempts [ 28 ], shoulder movements [ 58 ] during activities such as dressing or during transfer from lying to sitting [ 23 ], passive motion [ 55 ], during overhead activities and sleep [ 44 ]; two studies did not specify the activity [ 13 , 32 ]. The remaining 36 studies did not specify whether pain was measured during activity or at rest.…”

Effects of arthroscopy-guided suprascapular nerve block combined with ultrasound-guided interscalene brachial plexus block for arthroscopic rotator cuff repair: a randomized controlled trial

“…ANB has also been adopted for shoulder pain control and is mainly used in combination with SSNB [2,11,13,22]. There are a couple of studies which compare a regional block with epidural or spinal block [8,9]. One study reported that ultrasound-guided continuous ISB using 0.2 % ropivacaine may provide superior post-operative analgesia compared to ultrasound-guided continuous ISB using 0.75 % ropivacaine or fluoroscopy-guided targeted continuous cervical epidural block in arthroscopic cuff repair [9].…”

Risk factors for occurrence of failed interscalene brachial plexus blocks for shoulder arthroscopy using 20 mL 0.5% ropivacaine: a randomised trial

“…Moreover, it allows one to reduce the dose of LA [1], shortens the time of the onset of RA [2], minimises the rate of failed blocks [3] and the occurrence of brachial plexopathy [4], as well as the frequency of other unwelcome adverse events, such as intravascular injections of cardio-or neurotoxic LA [5], and diaphragm paralysis [6,7] with respiratory disorder [8]. In the end, IPBP produces appropriate analgesia for the postoperative period compared with general anaesthesia, which improves patients' satisfaction [9,10].…”