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Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial.
Orthop J Sports Med. 2021 Jan; 9(1):2325967120970906.OJ

Abstract

BACKGROUND

Effective pain control in patients who have undergone arthroscopic rotator cuff surgery improves functional recovery and early mobilization. Interscalene blocks (ISBs), a widely used approach, are safe and provide fast pain relief; however, they are associated with complications. Another pain management strategy is the use of a suprascapular nerve block (SSNB).

HYPOTHESIS

We hypothesized that indwelling SSNB catheters are a more effective pain control method than single-shot ISBs. We also hypothesized that indwelling SSNB catheters will reduce the level of rebound pain and the demand for opioid analgesics.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

Included in this study were 93 patients who underwent arthroscopic rotator cuff surgery between May 2012 and January 2019. These patients were assigned to either the indwelling SSNB catheter group, the single-shot ISB group, or the control (sham/placebo) group (31 patients per group). Level of pain was measured with a visual analog scale (VAS; 0 to 10 [worst pain]) on the day of the operation. The preoperative VAS score was recorded at 6 AM on the day of operation, and the postoperative scores were recorded at 1, 8, and 16 hours after surgery and then every 8 hours until postoperative day 3.

RESULTS

The VAS pain scores were lower in the SSNB and ISB groups than in the control group up to postoperative hour (POH) 8, with the most significant difference at POH 8. At POH 1 and POH 8, the mean VAS scores for each group were 2.29 and 1.74 (SSNB), 2.59 and 2.50 (ISB), and 3.42 and 4.48 (control), respectively. VAS scores in the SSNB and ISB groups were consistently <3, compared with a mean VAS score of 3.1 ± 1.58 in the control group (P < .001). Compared with the ISB group, the SSNB group had significantly fewer side effects such as rebound pain duration as well as lower VAS scores (P < .001).

CONCLUSION

VAS scores were the lowest in the indwelling SSNB catheter group, with the most pronounced between-group difference in VAS scores at POH 8. Severity and recurring frequency of pain were lower in the indwelling SSNB catheter group than in the single-shot ISB group.

Authors+Show Affiliations

Shoulder & Elbow Clinic, Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.Shoulder & Elbow Clinic, Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.Shoulder & Elbow Clinic, Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.Shoulder & Elbow Clinic, Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33553443

Citation

Kim, Jung Youn, et al. "Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: a Randomized Controlled Trial." Orthopaedic Journal of Sports Medicine, vol. 9, no. 1, 2021, p. 2325967120970906.
Kim JY, Kang MW, Lee HW, et al. Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial. Orthop J Sports Med. 2021;9(1):2325967120970906.
Kim, J. Y., Kang, M. W., Lee, H. W., & Noh, K. C. (2021). Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine, 9(1), 2325967120970906. https://doi.org/10.1177/2325967120970906
Kim JY, et al. Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: a Randomized Controlled Trial. Orthop J Sports Med. 2021;9(1):2325967120970906. PubMed PMID: 33553443.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial. AU - Kim,Jung Youn, AU - Kang,Min Wook, AU - Lee,Ho Won, AU - Noh,Kyu Cheol, Y1 - 2021/01/22/ PY - 2020/06/15/received PY - 2020/07/01/accepted PY - 2021/2/8/entrez PY - 2021/2/9/pubmed PY - 2021/2/9/medline KW - rotator cuff KW - shoulder KW - suprascapular nerve block KW - visual analog scale SP - 2325967120970906 EP - 2325967120970906 JF - Orthopaedic journal of sports medicine JO - Orthop J Sports Med VL - 9 IS - 1 N2 - BACKGROUND: Effective pain control in patients who have undergone arthroscopic rotator cuff surgery improves functional recovery and early mobilization. Interscalene blocks (ISBs), a widely used approach, are safe and provide fast pain relief; however, they are associated with complications. Another pain management strategy is the use of a suprascapular nerve block (SSNB). HYPOTHESIS: We hypothesized that indwelling SSNB catheters are a more effective pain control method than single-shot ISBs. We also hypothesized that indwelling SSNB catheters will reduce the level of rebound pain and the demand for opioid analgesics. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Included in this study were 93 patients who underwent arthroscopic rotator cuff surgery between May 2012 and January 2019. These patients were assigned to either the indwelling SSNB catheter group, the single-shot ISB group, or the control (sham/placebo) group (31 patients per group). Level of pain was measured with a visual analog scale (VAS; 0 to 10 [worst pain]) on the day of the operation. The preoperative VAS score was recorded at 6 AM on the day of operation, and the postoperative scores were recorded at 1, 8, and 16 hours after surgery and then every 8 hours until postoperative day 3. RESULTS: The VAS pain scores were lower in the SSNB and ISB groups than in the control group up to postoperative hour (POH) 8, with the most significant difference at POH 8. At POH 1 and POH 8, the mean VAS scores for each group were 2.29 and 1.74 (SSNB), 2.59 and 2.50 (ISB), and 3.42 and 4.48 (control), respectively. VAS scores in the SSNB and ISB groups were consistently <3, compared with a mean VAS score of 3.1 ± 1.58 in the control group (P < .001). Compared with the ISB group, the SSNB group had significantly fewer side effects such as rebound pain duration as well as lower VAS scores (P < .001). CONCLUSION: VAS scores were the lowest in the indwelling SSNB catheter group, with the most pronounced between-group difference in VAS scores at POH 8. Severity and recurring frequency of pain were lower in the indwelling SSNB catheter group than in the single-shot ISB group. SN - 2325-9671 UR - https://www.unboundmedicine.com/medline/citation/33553443/Suprascapular_Nerve_Block_Is_an_Effective_Pain_Control_Method_in_Patients_Undergoing_Arthroscopic_Rotator_Cuff_Repair:_A_Randomized_Controlled_Trial_ DB - PRIME DP - Unbound Medicine ER -
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