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Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial
Turk J Med Sci. 2021 06 28; 51(3):1317-1323.TJ

Abstract

Background/aim

The aim of this study was to compare the effects of local infiltration analgesia and interscalene brachial plexus block techniques on postoperative pain control and shoulder functional scores in patients undergoing arthroscopic rotator cuff repair.

Materials and methods

Sixty patients who underwent arthroscopic rotator cuff repair were prospectively included in the study. Patients were randomly divided into two groups. Group 1 was comprised of patients who had interscalene brachial plexus block, while group 2 was comprised of patients who had local infiltration analgesia. In group 1, interscalene block was applied with 20 mL 0.5% bupivacaine. In group 2, the Ranawat cocktail was used for local infiltration analgesia. Sixty milliliters of Ranawat cocktail was applied to the subacromial space and glenohumeral joint in equal amounts. Postoperative pain was assessed by the VAS score. Functional scores of the shoulder were also evaluated by Constant–Murley and UCLA scores. The time of first analgesic requirement and total analgesic consumption in the postoperative period were assessed.

Results

The first analgesic requirement was significantly late in the interscalene brachial plexus block group (p = 0.000). There was no statistically significant difference between the groups in terms of total analgesic consumption (p = 0.204). In the postoperative 6th h, the VAS score was 2.43 in the interscalene brachial plexus block group, whereas 2.86 in the local infiltration analgesia group (p = 0.323). There was no statistically significant difference between the groups in terms of Constant–Murley shoulder and UCLA scores in the 3rd postoperative month (respectively, p = 0.929, p = 0.671). Besides, postoperative VAS scores and functional scores were negatively correlated (p < 0.01).

Conclusion

Local infiltration analgesia is an effective alternative to interscalene brachial plexus block for postoperative pain management and total analgesic consumption in arthroscopic rotator cuff repair. However, the interscalene brachial plexus block provides a longer postoperative painless period.

Authors+Show Affiliations

Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, TurkeyDepartment of Orthopedics and Traumatology, Private Ortadogu Hospital, Ankara, TurkeyDepartment of Anesthesiology, Ankara City Hospital, Ankara, TurkeyDepartment of Orthopedics and Traumatology, Ankara City Hospital, Ankara, TurkeyDepartment of Orthopedics and Traumatology, Ankara City Hospital, Ankara, TurkeyDepartment of Orthopedics and Traumatology, Sinop Boyabat 75. Yıl Hospital, Sinop, Turkey

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

33512814

Citation

Bingöl, Olgun, et al. "Comparison of Local Infiltration Analgesia and Interscalene Block for Postoperative Pain Management in Shoulder Arthroscopy: a Prospective Randomized Controlled Trial." Turkish Journal of Medical Sciences, vol. 51, no. 3, 2021, pp. 1317-1323.
Bingöl O, Deveci A, Başkan S, et al. Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial. Turk J Med Sci. 2021;51(3):1317-1323.
Bingöl, O., Deveci, A., Başkan, S., Özdemir, G., Kılıç, E., & Arslantaş, E. (2021). Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial. Turkish Journal of Medical Sciences, 51(3), 1317-1323. https://doi.org/10.3906/sag-2008-57
Bingöl O, et al. Comparison of Local Infiltration Analgesia and Interscalene Block for Postoperative Pain Management in Shoulder Arthroscopy: a Prospective Randomized Controlled Trial. Turk J Med Sci. 2021 06 28;51(3):1317-1323. PubMed PMID: 33512814.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial AU - Bingöl,Olgun, AU - Deveci,Alper, AU - Başkan,Semih, AU - Özdemir,Güzelali, AU - Kılıç,Enver, AU - Arslantaş,Emrah, Y1 - 2021/06/28/ PY - 2020/08/08/received PY - 2021/01/28/accepted PY - 2021/1/29/entrez PY - 2021/1/30/pubmed PY - 2021/12/15/medline KW - Functional scores KW - interscalene block KW - local infiltration analgesia KW - postoperative pain management KW - rotator cuff repair KW - shoulder arthroscopy SP - 1317 EP - 1323 JF - Turkish journal of medical sciences JO - Turk J Med Sci VL - 51 IS - 3 N2 - Background/aim: The aim of this study was to compare the effects of local infiltration analgesia and interscalene brachial plexus block techniques on postoperative pain control and shoulder functional scores in patients undergoing arthroscopic rotator cuff repair. Materials and methods: Sixty patients who underwent arthroscopic rotator cuff repair were prospectively included in the study. Patients were randomly divided into two groups. Group 1 was comprised of patients who had interscalene brachial plexus block, while group 2 was comprised of patients who had local infiltration analgesia. In group 1, interscalene block was applied with 20 mL 0.5% bupivacaine. In group 2, the Ranawat cocktail was used for local infiltration analgesia. Sixty milliliters of Ranawat cocktail was applied to the subacromial space and glenohumeral joint in equal amounts. Postoperative pain was assessed by the VAS score. Functional scores of the shoulder were also evaluated by Constant–Murley and UCLA scores. The time of first analgesic requirement and total analgesic consumption in the postoperative period were assessed. Results: The first analgesic requirement was significantly late in the interscalene brachial plexus block group (p = 0.000). There was no statistically significant difference between the groups in terms of total analgesic consumption (p = 0.204). In the postoperative 6th h, the VAS score was 2.43 in the interscalene brachial plexus block group, whereas 2.86 in the local infiltration analgesia group (p = 0.323). There was no statistically significant difference between the groups in terms of Constant–Murley shoulder and UCLA scores in the 3rd postoperative month (respectively, p = 0.929, p = 0.671). Besides, postoperative VAS scores and functional scores were negatively correlated (p < 0.01). Conclusion: Local infiltration analgesia is an effective alternative to interscalene brachial plexus block for postoperative pain management and total analgesic consumption in arthroscopic rotator cuff repair. However, the interscalene brachial plexus block provides a longer postoperative painless period. SN - 1303-6165 UR - https://www.unboundmedicine.com/medline/citation/33512814/Comparison_of_local_infiltration_analgesia_and_interscalene_block_for_postoperative_pain_management_in_shoulder_arthroscopy:_a_prospective_randomized_controlled_trial DB - PRIME DP - Unbound Medicine ER -