Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control
ABSTRACT Objective: This trial investigated postoperative analgesia in arthroscopic rotator cuff repair surgery patients under general anesthesia, associated with ultrasound-guided peri-plexus interscalene brachial plexus block (US-IBPB), and compared single injection to elastomeric pump continuous...
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Thieme Revinter Publicações Ltda.
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| Series: | Revista Brasileira de Ortopedia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162018000600721&lng=en&tlng=en |
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| author | Leandro Cardoso Gomide Roberto Araújo Ruzi Beatriz Lemos Silva Mandim Vanessa Alves da Rocha Dias Rogério Henrique Dias Freire |
| author_facet | Leandro Cardoso Gomide Roberto Araújo Ruzi Beatriz Lemos Silva Mandim Vanessa Alves da Rocha Dias Rogério Henrique Dias Freire |
| author_sort | Leandro Cardoso Gomide |
| collection | DOAJ |
| description | ABSTRACT Objective: This trial investigated postoperative analgesia in arthroscopic rotator cuff repair surgery patients under general anesthesia, associated with ultrasound-guided peri-plexus interscalene brachial plexus block (US-IBPB), and compared single injection to elastomeric pump continuous infusion of local anesthetics. Complications associated to both techniques are described. Methods: In this prospective, quasi-randomized controlled clinical trial, 68 adults scheduled for elective arthroscopic rotator cuff repair were assigned to receive Group 1 (G1 = 41) US-IBPB with a 20 mL injection of 0.5% peri-plexus ropivacaine, introduction of catheter, injection of 20 mL of 0.5% ropivacaine through continuous catheter infusion of local anesthetic by elastomeric pump (ropivacaine 0.2%, infusion of 5 mL/h). In Group 2 (G2 = 27), US-IBPB, with a single peri-plexus injection of 40 mL ropivacaine 0.5%. In both groups oral analgesics were prescribed, paracetamol 500 mg associated to codeine 30 mg for patients with VAS between 3 and 5, and also oxycodone 20 mg for VAS ≥ 6. The anesthesiology team was available through contact telephones and the patients received a table to complete in order to report pain intensity according to VAS, use of oral medication, and complications related to the catheter and pump, until the third postoperative day. Results: The intensity of pain was higher on second day after surgery than on days 1 and 3, in both groups confirmed by the ANOVA test (p = 0.00006) Among the groups, G1 patients had lower pain intensity than G2, (p = 0.000197). G2 patients presented greater pain intensity during all periods studied (days 1, 2, and 3) than G1 patients. Postoperatively, G2 patients had higher consumption of rescue analgesics, nausea, and vomiting (40.74%) vs. G1 (5%) and dizziness (25.92%). No patient with catheter and elastomeric pump (G1) had complications regarding its insertion and maintenance during postoperative period. Conclusion: The quality of analgesia for arthroscopic rotator cuff repair with peri-plexus US-IBPB and continuous infusion with elastomeric pump presented superior postoperative analgesia quality to single puncture IBPB on postoperative days 2 and 3, with lower consumption of rescue opioids in this period. |
| first_indexed | 2024-03-07T16:39:44Z |
| format | Article |
| id | doaj.art-c0108884c65b4ac69a0b81ea9e61f02f |
| institution | Directory Open Access Journal |
| issn | 1982-4378 |
| language | English |
| last_indexed | 2024-03-07T16:39:44Z |
| publisher | Thieme Revinter Publicações Ltda. |
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| series | Revista Brasileira de Ortopedia |
| spelling | doaj.art-c0108884c65b4ac69a0b81ea9e61f02f2024-03-03T08:38:38ZengThieme Revinter Publicações Ltda.Revista Brasileira de Ortopedia1982-437853672172710.1016/j.rboe.2017.08.020S0102-36162018000600721Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain controlLeandro Cardoso GomideRoberto Araújo RuziBeatriz Lemos Silva MandimVanessa Alves da Rocha DiasRogério Henrique Dias FreireABSTRACT Objective: This trial investigated postoperative analgesia in arthroscopic rotator cuff repair surgery patients under general anesthesia, associated with ultrasound-guided peri-plexus interscalene brachial plexus block (US-IBPB), and compared single injection to elastomeric pump continuous infusion of local anesthetics. Complications associated to both techniques are described. Methods: In this prospective, quasi-randomized controlled clinical trial, 68 adults scheduled for elective arthroscopic rotator cuff repair were assigned to receive Group 1 (G1 = 41) US-IBPB with a 20 mL injection of 0.5% peri-plexus ropivacaine, introduction of catheter, injection of 20 mL of 0.5% ropivacaine through continuous catheter infusion of local anesthetic by elastomeric pump (ropivacaine 0.2%, infusion of 5 mL/h). In Group 2 (G2 = 27), US-IBPB, with a single peri-plexus injection of 40 mL ropivacaine 0.5%. In both groups oral analgesics were prescribed, paracetamol 500 mg associated to codeine 30 mg for patients with VAS between 3 and 5, and also oxycodone 20 mg for VAS ≥ 6. The anesthesiology team was available through contact telephones and the patients received a table to complete in order to report pain intensity according to VAS, use of oral medication, and complications related to the catheter and pump, until the third postoperative day. Results: The intensity of pain was higher on second day after surgery than on days 1 and 3, in both groups confirmed by the ANOVA test (p = 0.00006) Among the groups, G1 patients had lower pain intensity than G2, (p = 0.000197). G2 patients presented greater pain intensity during all periods studied (days 1, 2, and 3) than G1 patients. Postoperatively, G2 patients had higher consumption of rescue analgesics, nausea, and vomiting (40.74%) vs. G1 (5%) and dizziness (25.92%). No patient with catheter and elastomeric pump (G1) had complications regarding its insertion and maintenance during postoperative period. Conclusion: The quality of analgesia for arthroscopic rotator cuff repair with peri-plexus US-IBPB and continuous infusion with elastomeric pump presented superior postoperative analgesia quality to single puncture IBPB on postoperative days 2 and 3, with lower consumption of rescue opioids in this period.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162018000600721&lng=en&tlng=enRotator cuffArthroscopicShoulderPostoperative painBrachial plexus |
| spellingShingle | Leandro Cardoso Gomide Roberto Araújo Ruzi Beatriz Lemos Silva Mandim Vanessa Alves da Rocha Dias Rogério Henrique Dias Freire Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control Revista Brasileira de Ortopedia Rotator cuff Arthroscopic Shoulder Postoperative pain Brachial plexus |
| title | Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control |
| title_full | Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control |
| title_fullStr | Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control |
| title_full_unstemmed | Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control |
| title_short | Prospective study of ultrasound-guided peri-plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control |
| title_sort | prospective study of ultrasound guided peri plexus interscalene block with continuous infusion catheter for arthroscopic rotator cuff repair and postoperative pain control |
| topic | Rotator cuff Arthroscopic Shoulder Postoperative pain Brachial plexus |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162018000600721&lng=en&tlng=en |
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