Comparison of analgesic efficacy between single interscalene block combined with a continuous intra-bursal infusion of ropivacaine and continuous interscalene block after arthroscopic rotator cuff repair

Clin Orthop Surg. 2009 Mar;1(1):48-53. doi: 10.4055/cios.2009.1.1.48. Epub 2009 Feb 6.

Abstract

Background: This study evaluated the effectiveness of a continuous interscalene block (CISB) by comparing it with that of a single interscalene block combined with a continuous intra-bursal infusion of ropivacaine (ISB-IB) after arthroscopic rotator cuff repair.

Methods: Patients who had undergone CISB (CISB group; n = 25) were compared with those who had undergone ISB-IB (ISB-IB group; n = 25) for more than 48 hours after surgery. The visual analog scale (VAS) for pain, motor and/or sensory deficit, supplementary analgesics and adverse effects were recorded.

Results: There were no significant differences between the postoperative VAS of the CISB and ISB-IB groups, except at 1 hour after surgery. Their supplementary analgesics of the two groups were similar. Transient motor weakness (52%) and sensory disturbance (40%) of the affected arm were observed in patients in the CISB group. The catheters came out accidentally in 22% of the CISB group but in only 4% of the ISB-IB group.

Conclusions: ISB-IB provides similar analgesia to CISB. However, the ISB-IB group had a lower incidence of neurological deficits and better catheter retention.

Keywords: Arthroscopic rotator cuff repair; Continuous interscalene block; Postoperative pain control; Rotator cuff tear; Shoulder; Single interscalene block with intra-bursal infusion.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Amides / administration & dosage*
  • Analgesia / methods*
  • Anesthetics, Local / administration & dosage*
  • Arthroscopy
  • Bursa, Synovial
  • Case-Control Studies
  • Female
  • Humans
  • Infusions, Intralesional
  • Male
  • Middle Aged
  • Nerve Block*
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Prospective Studies
  • Ropivacaine
  • Rotator Cuff / surgery*
  • Shoulder Joint / surgery

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine