Post-operative pain control following arthroscopic rotator cuff repair: peri-articular injection versus interscalene brachial plexus block

Abstract

Although IBPB provided superior pain control during the initial few hours after ARCR surgery, PI was superior from 16 to 24 hours post-operatively. The rates of side effects, such as nausea and temporary arm numbness, were also lower in the PI group than in the IBPB group.

A comparison of ice wrap and subacromial injection for postoperative pain and edema control following arthroscopic rotator cuff repair

“…Cryotherapy, ice wrap, and subacromial injection/infusion have been used for postoperative pain control in ARCR surgery, but the effectiveness of each is still controversial [1,[3][4][5][6].…”

“…In the SI group, a significant improvement in the VAS score (compared to the preoperative VAS) was seen earlier than in the ice wrap group. Saito et al [3] stated that SI had a slow analgesic effect (this effect was not felt until the day after surgery), which could cause problems when SI is used to control acute postoperative pain. Cho et al [31] mentioned that SI had a significant analgesic effect 3 days after surgery compared to a placebo.…”

“…Pain management is crucial to ensuring rapid rehabilitation and early discharge following the procedure [2]. Numerous pain management modalities have been described, including opioid analgesics, interscalene brachial plexus nerve block, suprascapular nerve block, periarticular analgesic injection, cryotherapy, and ice wrap [1,[3][4][5][6]. Among these, cryotherapy seems to be associated with less morbidity than the other modalities and appears to be effective at reducing pain compared to control groups [7,8].…”

Editorial Commentary: Postoperative Pain Management After Arthroscopic Rotator Cuff Repair: The Journey to Pain Relief

“…Liu and others reported that the effect of ISB weans after 6 hours. [5][6][7] ISB is ineffective especially when administered after a prolonged postoperative duration, and when the pain relapses.…”

Comment on Medina et al.: orthopaedic surgery patients who use recreational marijuana have less pre-operative pain

“…The authors performed an observational study on 997 patients undergoing outpatient orthopaedic surgery and concluded that marijuana use was an independent factor associated with less pain intensity in the operative site. The authors should be applauded for performing a well-designed study in an important topic (e.g., acute pain) in patients undergoing orthopaedic surgery [2,3]. The need to improve post-operative recovery by reducing moderate-to-severe post-operative pain makes the topic very important in peri-operative medicine [4,5].…”