Continuous intra-lesional Infusion Combined with Interscalene Block for Effective Postoperative Analgesia after Arthroscopic Shoulder Surgery

doi:2005.8.2.141

Clin Shoulder Elb > Volume 8(2); 2005 > Article

Journal of the Korean Shoulder and Elbow Society 2005;8(2):141-147.
DOI: https://doi.org/10.5397/CiSE.2005.8.2.141 Published online December 30, 2005.

Continuous intra-lesional Infusion Combined with Interscalene Block for Effective Postoperative Analgesia after Arthroscopic Shoulder Surgery

Joo Han Oh, M.D., Woo Sung Kim, M.D.**, Jae Yoon Kim, M.D., Hyun Sik Gong, M.D., Jae Kwang Kim, M.D., Sang Gee Kim, M.D., Tae Yune Kim, M.D. and Ka-young Rhee*, M.D.

Department of Orthopaedic Surgery, Seoul National University College of Medicine, Department of Anesthesiology^*
Konkuk University College of Medicine, Seoul Korea

상완신경총 사각근간 차단과 국소마취제의 병소내 지속주입법의 병용 이 견관절경 수술 후 진통에 미치는 영향

오주한, 김우성, 김재윤, 공현식, 김재광, 이상기, 김태윤, 이가영

서울대학교 의과대학 정형외과학교실, 건국대학교 의과대학 마취통증의학교실*

Abstract

Purpose
The purpose of this study was to compare the effectiveness of postoperative pain control by intravenous patient-controlled analgesia (IV) to the effectiveness of postoperative pain control by continuous intra-lesional infusion of local anesthetics (IL) with or without an interscalene brachial plexus block (ISB) after arthroscopic shoulder surgery. Materials and Methods: We designed this prospective randomized case-controlled double-blind study, and allocated 84 consecutive patients to four groups according to postoperative analgesic method, i.e., Group IV, Group ISBIV, Group IL, and Group ISB-IL after arthroscopic shoulder surgery. Postoperative pain, side effects and supplemental analgesics were recorded at 1 hour and then at every 8 hours for 2 days. Result: The demographic and clinical characteristics of four groups were identical statistically. Interscalene block (Group ISB-IV, Group ISB-IL) was found to be effective at relieving pain and at reducing supplemental analgesic amounts at 1 and 8 hours postoperatively (p<0.05). Patients in the Group ISB-IL had less pain at 16 and 48 hours postoperatively than the other groups (p<0.05). Continuous intra-lesional infusion (Group IL, Group ISB-IL) was superior in reducing analgesic-related side effects (p<0.05). Conclusion: This study suggests that a combination of an interscalene brachial plexus block and continuous intra lesional infusion of ropivacaine is an effective and safe method of postoperative pain control in patients after arthroscopic shoulder surgery.

Key Words: Shoulder, Arthroscopy, Postoperative pain control, Interscalene brachial plexus block, Continuous intra-lesional infusion