Patient-controlled analgesia after arthroscopic rotator cuff repair: subacromial catheter versus intravenous injection.

Abstract

BACKGROUND:

No study has compared pain control results between patient-controlled subacromial infusion and intravenous injection after arthroscopic shoulder surgery.

HYPOTHESIS:

Subacromial infusion of analgesics are more effective in pain alleviation than intravenous injection.

STUDY DESIGN:

Randomized controlled clinical trial; Level of evidence, 2.

METHODS:

The authors prospectively analyzed 40 cases of arthroscopic rotator cuff repair that received patient-controlled analgesia. They divided the 40 cases into 2 groups: subacromial infusion group with 0.5% bupivacaine (group 1, 20 cases) and intravenous injection group with fentanyl and ketorolac tromethamine (group 2, 20 cases). The visual analog scale was used to record the patient's level of pain every 12 hours until postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia.

RESULTS:

The mean preoperative visual analog scale score during motions was 6.8 in group 1 and 5.8 in group 2. The immediate postoperative visual analog scale score was 7.6 and 7.4, respectively, for each group. At postoperative time periods, most of the scores of subacromial infusion at rest and during motions were lower than those of intravenous injection, but significant differences were not found between groups 1 and 2.

CONCLUSION:

Patient-controlled analgesia after arthroscopic rotator cuff repair showed that both subacromial infusion of bupivacaine and intravenous injection of fentanyl and ketorolac tromethamine were equally effective and clinically equivalent pain control methods.

• Authors: Nam Su Cho, Jeong Han Ha, Yong Girl Rhee
• Journal: The American journal of sports medicine (Am J Sports Med) Vol. 35 Issue 1 Pg. 75-9 (Jan 2007) ISSN: 0363-5465 [Print] United States
• PMID: 16923824 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anesthetics, Intravenous
• Anesthetics, Local
• Anti-Inflammatory Agents, Non-Steroidal
• Fentanyl
• Bupivacaine
• Ketorolac

Topics

• Adult
• Aged
• Analgesia, Patient-Controlled (methods)
• Anesthetics, Intravenous (administration & dosage)
• Anesthetics, Local (administration & dosage)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
• Arthroscopy
• Bupivacaine (administration & dosage)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Fentanyl (administration & dosage)
• Humans
• Injections, Intravenous
• Ketorolac (administration & dosage)
• Male
• Middle Aged
• Pain Measurement
• Pain, Postoperative (drug therapy)
• Rotator Cuff (surgery)
• Rotator Cuff Injuries
• Treatment Outcome