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Clin Shoulder Elb > Volume 15(1); 2012 > Article
Clinics in Shoulder and Elbow 2012;15(1):1-7.
DOI: https://doi.org/10.5397/CiSE.2012.15.1.1    Published online June 30, 2012.
Effectiveness of Multimodal Pain Control in Early Phase After Arthroscopic Rotator Cuff Repair
Chang Min Park, Jong Hae Kim, Suk Jun Kim, Chang Hyuk Choi
1Department of Orthopaedic Surgery, College of Medicine, Catholic University of Daegu, Daegu, Korea. chchoi@cu.ac.kr
2Department of Anesthesiology and Pain Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea.
관절경하 회전근 개 봉합술 후 다중 통증 조절법을 이용한 초기 통증 조절의 유용성
박창민·김종해*·김석준·최창혁
대구 가톨릭대학병원 정형외과학교실, 대구 가톨릭대학병원 마취통증의학교실
Abstract
PURPOSE
The purpose of this study was to identify the effectiveness of multimodal pain control method in an early phase after arthroscopic rotator cuff repair, under interscalene brachial plexus block, this study was performed. MATERIALS AND METHODS: The study was progressed with the 80 cases of arthroscopic rotator cuff repair. Interscalene brachial plexus block was used to all of the 80 cases and patients were divided into 2 groups. Group A consisted of patients injected with bupivacaine, through subacromial space catheter after surgery, and group B consisted of patients with additional method of multimodal pain control using oral opioids, acetaminophen-tramadol complex and selective COX2 inhibitor. Subacromial cathter was removed after injection in both groups. The pain during the day time and night time was compared on the operation day, postoperative 1st, 2nd, 3rd day and 2nd weeks, and it was measured with VAS (visual analogue scale) score. Additionally, the number of ketolorac injection and side-effect related to analgesics was compared between the 2 groups.
RESULTS
The mean VAS score of night time on the operation day and day/night time pain of the 1st, 2nd, 3rd day and 2nd weeks was 7.4, 7.0/6.8, 4.5/5.2, 4.8/5.0, 2.2/2.7 on group A and 6.5, 4.3/5.4, 3.2/4.3, 3.0/4.1, 2.4/2.5 on group B, respectively. Significant difference was observed in the night pain on the operation day, 1st, 2nd, 3rd day time and 1st night time pain (p<.05). The average number of ketololac injection was 1.1 and 0.5 in each group, and there was no difference in the frequency of side effects.
CONCLUSION
Multimodal pain control method, after arthroscopic rotator cuff repair, showed an effective early pain control and improved patients' satisfaction.
Key Words: Rotator cuff tear; Brachial plexus block; Arthroscopic rotator cuff repair; Multimodal pain control


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