Subacromial patient-controlled analgesia with ropivacaine provides effective pain control after arthroscopic rotator cuff repair

Yun, Mi Ja; Oh, Joo Han; Yoon, Jong Pil; Park, Sang Hyun; Hwang, Jung Won; Kil, Ho

doi:10.1007/s00167-011-1841-1

Cited by 12 publications

(26 citation statements)

References 32 publications

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“…Yun et al. compared patient‐controlled subacromial ropivacaine administration with i.v. PCA comprising fentanyl, ketorolac and ondansetron, and found lower pain scores for subacromial infusion at 1 h after surgery and no difference in opioid consumption.…”

Section: Resultsmentioning

confidence: 99%

PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure‐specific postoperative pain management recommendations

et al. 2019

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Summary Rotator cuff repair can be associated with significant and difficult to treat postoperative pain. We aimed to evaluate the available literature and develop recommendations for optimal pain management after rotator cuff repair. A systematic review using procedure‐specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in English from 1 January 2006 to 15 April 2019 assessing postoperative pain after rotator cuff repair using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. Out of 322 eligible studies identified, 59 randomised controlled trials and one systematic review met the inclusion criteria. Pre‐operative and intra‐operative interventions that improved postoperative pain were paracetamol, cyclo‐oxygenase‐2 inhibitors, intravenous dexamethasone, regional analgesia techniques including interscalene block or suprascapular nerve block (with or without axillary nerve block) and arthroscopic surgical technique. Limited evidence was found for pre‐operative gabapentin, perineural adjuncts (opioids, glucocorticoids, or α‐2‐adrenoceptor agonists added to the local anaesthetic solution) or postoperative transcutaneous electrical nerve stimulation. Inconsistent evidence was found for subacromial/intra‐articular injection, and for surgical technique‐linked interventions, such as platelet‐rich plasma. No evidence was found for stellate ganglion block, cervical epidural block, specific postoperative rehabilitation protocols or postoperative compressive cryotherapy. The analgesic regimen for rotator cuff repair should include an arthroscopic approach, paracetamol, non‐steroidal anti‐inflammatory drugs, dexamethasone and a regional analgesic technique (either interscalene block or suprascapular nerve block with or without axillary nerve block), with opioids as rescue analgesics. Further randomised controlled trials are required to confirm the influence of the recommended analgesic regimen on postoperative pain relief.

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Section: Resultsmentioning

confidence: 99%

PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure‐specific postoperative pain management recommendations

et al. 2019

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“…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 ].…”

Section: Resultsmentioning

confidence: 99%

“…The number of pain recordings decreased from POD2 to POD6 with a small increase in POD7. The time points in POD1 were specified in 32 of the included studies and represented 28 different time points ( Figure 5 ) [ 10 – 12 , 14 , 19 – 21 , 23 , 26 – 28 , 30 , 31 , 33 – 38 , 43 , 46 – 52 , 54 – 57 , 59 ]. The most frequently used time points were: post-anaesthesia care unit, 1, 2, 4, 6, 8, 12, and 24 hours postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…In most cases, only the rescue analgesics were recorded (in mg or number of doses) [ 14 , 21 , 24 , 47 , 49 ], or the number of patients requesting [ 34 , 54 , 56 ] (or not requesting) analgesics [ 19 ]. For patients using patient-controlled analgesia (PCA, usually with intravenous opioid), the number of attempts, number of doses, and/or cumulated dose (for example during 24 hours) were reported [ 31 , 37 , 41 , 48 , 50 , 52 , 57 ]. Some studies reported total consumption of morphine/opioids [ 12 , 13 , 47 ] or cumulated amount of all analgesics [ 10 , 15 ] during a specific period of time.…”

Section: Resultsmentioning

confidence: 99%

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

Rasmussen

Nikolajsen

Bjørnholdt

2018

SICOT-J

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Introduction: Pain can be severe during the first days after arthroscopic surgery, and acute pain is an important outcome in clinical trials of surgical technique or anaesthetic strategy. A standardized, validated method of assessing acute postoperative pain would improve the quality of clinical studies, and facilitate systematic reviews and meta-analyses. A step on the way towards this standard is to investigate the methods most commonly used in recent literature.Methods: PubMed and CINAHL databases were searched, including studies of arthroscopic rotator cuff surgery with a primary pain-related outcome during the first postoperative week, published in English from 2012 to 2017.Results: A total of 47 studies were included, all measuring pain intensity using a pain rating scale. Most frequently used was the visual analogue scale using the anchors “no pain” and “worst pain imaginable”, with recordings at 1, 2, 4, 6, 8, 12, and 24 hours postoperatively. A total of 34 studies recorded analgesic consumption, usually as average cumulated consumption in mg. Time to first analgesic request or first pain were recorded in 11 studies, and 4 different starting points were used.Discussion: This review describes the currently most common methods of assessing acute postoperative pain in clinical trials of arthroscopic shoulder surgery involving rotator cuff repair, and the large variety of methods applied. Based on this study and international guidelines, several recommendations on how to measure and report postoperative pain outcomes in future trials are proposed.

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“…Preoperatively, most patients (114 of 118, 96.6%) had their rotator cuffs evaluated with magnetic resonance imaging (MRI). Four patients underwent computed tomography arthrography (CTA) owing to the poor quality of Previous 3 prospective studies 11,18,30 Excluded: n = 41 Other than rotator cuff repair Excluded: n = 38 1. Continuous SA infusion (n = 2)…”

Section: Outcome Assessmentmentioning

confidence: 99%

Subacromial Local Anesthetics Do Not Interfere With Rotator Cuff Healing After Arthroscopic Repair

et al. 2018

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Subacromial patient-controlled analgesia with ropivacaine provides effective pain control after arthroscopic rotator cuff repair

Abstract: Therapeutic study, Level I.

Cited by 12 publications

References 32 publications

PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure‐specific postoperative pain management recommendations

PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure‐specific postoperative pain management recommendations

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

Subacromial Local Anesthetics Do Not Interfere With Rotator Cuff Healing After Arthroscopic Repair

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