European Journal of Biomedical and Pharmaceutical Sciences

A RANDOMIZED COMPARATIVE STUDY OF POSTOPERATIVE ANALGESIA BETWEEN CONTINUOUS INTERSCALENE BLOCK AND INTRA-ARTICULAR INFUSION OF BUPIVACAINE IN ARTHROSCOPIC ROTATOR CUFF REPAIR SURGERY

Tomoki Nishiyama*

ABSTRACT

The present study was performed to compare postoperative analgesic effects between continuous interscalene block and continuous intra-articular administration of local anesthetic in arthroscopic rotator cuff repair (ARCR). Ninety patients aged 20 to 70 years for ARCR were divided into three groups. Interscalene block was performed using ultrasound and nerve stimulation. Sedation was maintained with propofol 4 to 7 mg/kg/h. Bupivacaine 0.25% 2 mL/h of interscalene infusion in the IS group and intra-articular infusion in the IA group for 48 hours were started. In the Control (C) group, nothing was continuously administered. Visual analogue scale (VAS) score, and sensory and motor blocks were recorded for postoperative 48 hours. Time to the first postoperative analgesic and frequency of analgesic for postoperative 48 hours were recorded. VAS scores were significantly higher in the C group than other two groups after 4 hours. No statistical difference was observed between the IS and IA groups. C group had the shortest time to the first analgesic. Frequency of analgesic was the largest in the C group. No significant differences were observed between the IS and IA groups. After 8 hours, significantly larger numbers of patients showed sensory and motor blocks in the IS group. In conclusion, postoperative analgesic effects in ARCR were equivalent between continuous interscalene block and intra-articular infusion, both with 0.25% bupivacaine 2 mL/h. However, interscalene block induced longer motor and sensory blocks.

Keywords: arthroscopic shoulder surgery; postoperative analgesia; interscalene block; intra-articular injection; bupivacaine.