Subacromial bursa block is an effective alternative to interscalene block for postoperative pain control after arthroscopic subacromial decompression: A randomized trial

Subacromial decompression surgery is associated with significant postoperative pain. We compared interscalene block (ISB) with subacromial bursa block (SBB). Sixty consecutive patients with subacromial impingement syndrome, scheduled for arthroscopic subacromial decompression surgery, were randomize...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2008, Vol.17 (1), p.78-84
Main Authors: Nisar, Aamer, MRCS, Morris, Matthew W.J., MRCS, Freeman, Jennifer V., PhD, Cort, Jonathan M., FRCA, Rayner, Philip R., FRCA, Shahane, Shantanu A., FRCS(Orth)
Format: Article
Language:English
Subjects:
Acromion - surgery
Adult
Aged
Aged, 80 and over
Arthroscopy
Biological and medical sciences
Decompression, Surgical
Endoscopy
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Nerve Block - methods
Orthopedics
Pain, Postoperative - prevention & control
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Summary:Subacromial decompression surgery is associated with significant postoperative pain. We compared interscalene block (ISB) with subacromial bursa block (SBB). Sixty consecutive patients with subacromial impingement syndrome, scheduled for arthroscopic subacromial decompression surgery, were randomized into 3 groups receiving ISB (n = 19), SBB (n = 19), or no block (n = 15 [controls]). Patients with rotator cuff tears were excluded (n = 7). The postoperative consumption of morphine, time to the first bolus of morphine, oral analgesia, pain, sickness, and sedation scores were recorded. The pain scores in the ISB and SBB groups were lower than those in the control group in the first 12 hours postoperatively. The control group consumed more morphine (mean, 32.3 mg) compared with the SBB group (mean, 21.21 mg) and ISB group (mean, 14.00 mg) ( P < .001). The time to first bolus was earlier in the control group (mean, 42.1 minutes) compared with both the SBB (mean, 92.6 minutes) and ISB (mean, 119.0 minutes) groups ( P < .001). The oral analgesic intake was less in the SBB and ISB groups than in the controls ( P = .004). Although ISB remains the gold standard, SBB provides effective, safe, and easily administered postoperative analgesia in patients with an intact rotator cuff undergoing arthroscopic subacromial decompression.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2007.05.014