Efficacy of direct arthroscopy-guided suprascapular nerve block after arthroscopic rotator cuff repair: a prospective randomized study

Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):562-6. doi: 10.1007/s00167-013-2451-x. Epub 2013 Mar 1.

Abstract

Purpose: The purpose of this study was to evaluate the outcomes of arthroscopy-guided direct suprascapular nerve block performed after arthroscopic rotator cuff repair.

Methods: In the present prospective, randomized, double-blinded clinical study, 30 patients were divided into two groups: 15 patients (group I) were treated with arthroscopy-guided suprascapular nerve block using 10 mL 0.5 % ropivacaine with 1:200,000 epinephrine, and 15 patients (group II) were treated with placebo using 10 mL 0.9 % saline after arthroscopic rotator cuff repair. Patient pain levels were measured using the visual analog scale (VAS) at 1, 3, 6, 12, 18, and 24 h post-operatively. Additionally, the number of boluses and total amount of fentanyl dispensed by patient-controlled analgesia administration during the 24-h post-operative period were evaluated.

Results: VAS scores did not differ significantly between groups I and II during the 24-h post-operative period, but mean fentanyl bolus consumption was significantly less in group I compared with group II (p = 0.015).

Conclusion: Arthroscopy-guided suprascapular nerve block at the end of a rotator cuff repair was safe and less time-consuming than expected. Although this procedure did not significantly reduce the post-operative pain, the post-operative need for fentanyl boluses as analgesia was reduced significantly, and it would be beneficial if this procedure involved a sensory branch of axillary nerve block or was performed at the beginning of the arthroscopic procedure.

Level of evidence: Prospective, randomized, double-blinded clinical trial, Level I.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amides / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Arthroscopy
  • Double-Blind Method
  • Female
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Ropivacaine
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries
  • Treatment Outcome

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine