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Comparison of continuous and single interscalene block for quality of recovery score following arthroscopic rotator cuff repair.
J Orthop Surg (Hong Kong). 2021 Jan-Apr; 29(1):23094990211000142.JO

Abstract

BACKGROUND

Continuous interscalene brachial plexus block (CISB) is well known to reduce postoperative pain and to improve patient satisfaction. However, the effect of CISB on the quality of postoperative recovery is unknown. We Compared the quality of recovery from arthroscopic rotator cuff repair in patients who received CISB or single interscalene brachial plexus block (SISB).

METHODS

This prospective non-randomized controlled trial with propensity score matching enrolled 134 patients undergoing arthroscopic surgery for rotator cuff repair. Each patient received an interscalene block before surgery. One group had a catheter insertion 30 min after the end of surgery and started patient-controlled regional analgesia (PCRA, n = 49). The other group received intravenous patient-controlled analgesia (IV-PCA, n = 85). The primary outcome was the quality of recovery (QoR-40) score. Also, postoperative analgesia, sleep quality, and postoperative complications were evaluated.

RESULTS

The two groups had similar QoR-40 score on postoperative day-1 (POD1), but the PCRA group had a significantly greater QoR-40 score on POD2 (156.0, IQR: 143.0, 169.0 vs. 171.0, IQR: 159.0, 178.0; p < 0.001). The IV-PCA group received more analgesics during the 2 days after surgery, especially during night-time, and had a higher prevalence of sleep disturbances. The time to first additional analgesics request was significantly longer in PCRA group (14 hours, 95% CI: 13-16 vs. 44 hours, 95% CI: 28-not applicable). The incidence of postoperative nausea and vomiting significantly lower in the PCRA group (16.3% vs 46.9%, p = 0.002).

CONCLUSION

CISB showed a higher quality of recovery score than SISB with IV-PCA in arthroscopic rotator cuff repair, probably related to the effective analgesia, improved sleep quality, and reduced opioid-related complications.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Yun S
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, 26715Chungnam National University, Daejeon, Korea.
Jo Y
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea.
Sim S
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea.
Jeong K
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea.
Oh C
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, 26715Chungnam National University, Daejeon, Korea.
Kim B
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea.
Lee WY
Department of Orthopedic Surgery, 90159Chungnam National University Hospital and College of Medicine, Daejeon, Korea.
Park S
College of Nursing, 26715Chungnam National University, Daejeon, Republic of Korea.
Kim YH
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, 26715Chungnam National University, Daejeon, Korea.
Ko Y
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, 26715Chungnam National University, Daejeon, Korea.
Chung W
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, 26715Chungnam National University, Daejeon, Korea.
Hong B
Department of Anesthesiology and Pain Medicine, 65409Chungnam National University Hospital, Daejeon, Korea. Department of Anesthesiology and Pain Medicine, College of Medicine, 26715Chungnam National University, Daejeon, Korea.

MeSH

AgedAnalgesia, Patient-ControlledAnalgesicsAnalgesics, OpioidAnesthetics, LocalArthroplastyArthroscopyBrachial Plexus BlockFemaleHumansMaleMiddle AgedPain MeasurementPain, PostoperativePatient SatisfactionQuality of LifeRepublic of KoreaResearch DesignRotator CuffRotator Cuff Injuries

Pub Type(s)

Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33745379

Citation

Yun, Sangwon, et al. "Comparison of Continuous and Single Interscalene Block for Quality of Recovery Score Following Arthroscopic Rotator Cuff Repair." Journal of Orthopaedic Surgery (Hong Kong), vol. 29, no. 1, 2021, p. 23094990211000142.
Yun S, Jo Y, Sim S, et al. Comparison of continuous and single interscalene block for quality of recovery score following arthroscopic rotator cuff repair. J Orthop Surg (Hong Kong). 2021;29(1):23094990211000142.
Yun, S., Jo, Y., Sim, S., Jeong, K., Oh, C., Kim, B., Lee, W. Y., Park, S., Kim, Y. H., Ko, Y., Chung, W., & Hong, B. (2021). Comparison of continuous and single interscalene block for quality of recovery score following arthroscopic rotator cuff repair. Journal of Orthopaedic Surgery (Hong Kong), 29(1), 23094990211000142. https://doi.org/10.1177/23094990211000142
Yun S, et al. Comparison of Continuous and Single Interscalene Block for Quality of Recovery Score Following Arthroscopic Rotator Cuff Repair. J Orthop Surg (Hong Kong). 2021;29(1):23094990211000142. PubMed PMID: 33745379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of continuous and single interscalene block for quality of recovery score following arthroscopic rotator cuff repair. AU - Yun,Sangwon, AU - Jo,Yumin, AU - Sim,Seojin, AU - Jeong,Kuhee, AU - Oh,Chahyun, AU - Kim,Byungmuk, AU - Lee,Woo-Yong, AU - Park,Seyeon, AU - Kim,Yoon-Hee, AU - Ko,Youngkwon, AU - Chung,Woosuk, AU - Hong,Boohwi, PY - 2021/3/22/entrez PY - 2021/3/23/pubmed PY - 2021/7/22/medline KW - elbow & shoulder KW - nerve block KW - postoperative pain KW - quality of recovery SP - 23094990211000142 EP - 23094990211000142 JF - Journal of orthopaedic surgery (Hong Kong) JO - J Orthop Surg (Hong Kong) VL - 29 IS - 1 N2 - BACKGROUND: Continuous interscalene brachial plexus block (CISB) is well known to reduce postoperative pain and to improve patient satisfaction. However, the effect of CISB on the quality of postoperative recovery is unknown. We Compared the quality of recovery from arthroscopic rotator cuff repair in patients who received CISB or single interscalene brachial plexus block (SISB). METHODS: This prospective non-randomized controlled trial with propensity score matching enrolled 134 patients undergoing arthroscopic surgery for rotator cuff repair. Each patient received an interscalene block before surgery. One group had a catheter insertion 30 min after the end of surgery and started patient-controlled regional analgesia (PCRA, n = 49). The other group received intravenous patient-controlled analgesia (IV-PCA, n = 85). The primary outcome was the quality of recovery (QoR-40) score. Also, postoperative analgesia, sleep quality, and postoperative complications were evaluated. RESULTS: The two groups had similar QoR-40 score on postoperative day-1 (POD1), but the PCRA group had a significantly greater QoR-40 score on POD2 (156.0, IQR: 143.0, 169.0 vs. 171.0, IQR: 159.0, 178.0; p < 0.001). The IV-PCA group received more analgesics during the 2 days after surgery, especially during night-time, and had a higher prevalence of sleep disturbances. The time to first additional analgesics request was significantly longer in PCRA group (14 hours, 95% CI: 13-16 vs. 44 hours, 95% CI: 28-not applicable). The incidence of postoperative nausea and vomiting significantly lower in the PCRA group (16.3% vs 46.9%, p = 0.002). CONCLUSION: CISB showed a higher quality of recovery score than SISB with IV-PCA in arthroscopic rotator cuff repair, probably related to the effective analgesia, improved sleep quality, and reduced opioid-related complications. SN - 2309-4990 UR - https://www.unboundmedicine.com/medline/citation/33745379/Comparison_of_continuous_and_single_interscalene_block_for_quality_of_recovery_score_following_arthroscopic_rotator_cuff_repair_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓7]

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