Efficacy of Subacromial Ropivacaine Infusion for Rotator Cuff Surgery

Coghlan, Jennifer; Forbes, Andrew Benjamin; McKenzie, Dean Philip; Bell, Simon; Buchbinder, Rachelle

doi:10.2106/jbjs.h.00948

Cited by 53 publications

(47 citation statements)

References 23 publications

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“…However, it is difficult to directly compare the present results with other studies, for important methodological differences, since to our knowledge this is the first study of local anaesthesia with either control or IBPB groups in open shoulder instability surgery [2,8,10]. In particular, the comparison with a control group in relation with IBPB, the most commonly analgesic technique used in this surgery, using the same dose and volume of anaesthetics, allow improving the analgesic considerations.…”

Section: Discussionmentioning

confidence: 87%

“…The single local anaesthetic injection effectiveness for open shoulder surgery was previously poorly documented and not well defined [2,8,14], more data even if with discordant results have been reported that however were more related to the continuous infusion of anaesthetics and arthroscopic setting [5,9,[15][16][17]. Anyhow, a little clinical benefit of local infiltration was evidenced [3].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, various studies have demonstrated the need for valid anaesthetic techniques which allow adequate control of postoperative pain in order to facilitate recovery and favour early mobilization and rehabilitation [1,2]. Moreover, adequate management of postoperative pain continues to be a challenge after ambulatory surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Postoperative pain is usually managed by a variety of methods, including single shot and continuous interscalenic brachial plexus block (IBPB), patient-controlled analgesia (PCA) with opioids, continuous wound infiltration with local anaesthetics [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Most of the studies in the literature have investigated a continuous local anaesthetic infiltration in arthroscopic shoulder surgery and not in open shoulder surgery and specifically in the antero-inferior shoulder surgery [2,3,5,9,10]. Furthermore, not all have compared the local infiltration anaesthesia and the IBPB with a control group using the same volume and dose of anaesthetic in order to provide rigour to the study and to give the most appropriate clinical evaluations and comparisons.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Local Anaesthesia Efficacy as Postoperative Analgesia for Open Shoulder Instability Surgery: A Prospective Randomised Controlled Study

Fontana¹

2012

J Anesthe Clinic Res

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Local Anaesthesia Efficacy as Postoperative Analgesia for Open Shoulder Instability Surgery: A Prospective Randomised Controlled Study

Fontana¹

2012

J Anesthe Clinic Res

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Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

Andreae

2012

Cochrane Database of Systematic Reviews

102

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Background Regional anaesthesia may reduce the rate of persistent (chronic) pain after surgery, a frequent and debilitating condition. Objectives To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 4), PubMed (1966 to April 2012), EMBASE (1966 to May 2012) and CINAHL (1966 to May 2012) without any language restriction. We used a combination of free text search and controlled vocabulary search. The results were limited to randomized controlled clinical trials (RCTs). We conducted a handsearch in reference lists of included trials, review articles and conference abstracts. Selection criteria We included RCTs comparing local anaesthetics or regional anaesthesia versus conventional analgesia with a pain outcome at six or 12 months after surgery. Data collection and analysis Two authors independently assessed trial quality and extracted data, including information on adverse events. We contacted study authors for additional information. Results are presented as pooled odds ratios (OR) with 95% confidence intervals (CI), based on random-effects models (inverse variance method). We grouped studies according to surgical interventions. We employed the Chi2 test and calculated the I2 statistic to investigate study heterogeneity. Main results We identified 23 RCTs studying local anaesthetics or regional anaesthesia for the prevention of persistent (chronic) pain after surgery. Data from a total of 1090 patients with outcomes at six months and of 441 patients with outcomes at 12 months were presented. No study included children. We pooled data from 250 participants after thoracotomy, with outcomes at six months. Data favoured regional anaesthesia for the prevention of chronic pain at six months after thoracotomy with an OR of 0.33 (95% CI 0.20 to 0.56). We pooled two studies on paravertebral block for breast cancer surgery; the pooled data of 89 participants with outcomes at five to six months favoured paravertebral block with an OR of 0.37 (95% CI 0.14 to 0.94).The methodological quality of the included studies was intermediate. Adverse effects were not studied systematically and were reported sparsely. Clinical heterogeneity, attrition and sparse outcome data hampered the assessment of effects, especially at 12 months. Authors’ conclusions Epidural anaesthesia may reduce the risk of developing chronic pain after thoracotomy in about one patient out of every four patients treated. Paravertebral block may reduce the risk of chronic pain after breast cancer surgery in about one out of every five women treated. Our conclusions are significantly weakened by performance bias, shortcomings in allocation concealment, considerable attrition and incomplete outcome data. We caution that our evidence synthesis is based on only a few, small studies. More studies with high methodological quality, addre...

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Measures of Adult Shoulder Function

Buchbinder

Smolen

Huang

et al. 2020

Arthritis Care & Research

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Efficacy of Subacromial Ropivacaine Infusion for Rotator Cuff Surgery

Abstract: We found minimal evidence to support the use of ropivacaine infusion for improving outcomes following rotator cuff surgery in the setting of preemptive ropivacaine and intraoperative parecoxib.

Cited by 53 publications

References 23 publications

Local Anaesthesia Efficacy as Postoperative Analgesia for Open Shoulder Instability Surgery: A Prospective Randomised Controlled Study

Local Anaesthesia Efficacy as Postoperative Analgesia for Open Shoulder Instability Surgery: A Prospective Randomised Controlled Study

Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

Measures of Adult Shoulder Function

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