-Case Reports-

Nerve Block for Pain Relief During Arthroscopic Rotator Cuff Repair

Satoshi Iwashita, Hiroshi Hashiguchi, Atsushi Okubo, Minoru Yoneda and Shinro Takai

Department of Orthopaedic Surgery, Nippon Medical School Hospital

Background: Although arthroscopic rotator cuff repair (ARCR) often results in good outcomes, some patients have severe pain postoperatively. This study investigated the efficacy of nerve block for ARCR.
Methods: This study was retrospective, and consent was obtained from all patients. We divided 50 patients who had undergone ARCR into 4 groups: continuous interscalene nerve block was performed for 11 patients (continuous-injection group), single interscalene nerve block for 10 (single-injection group), suprascapular nerve block for 8 (suprascapular group), and intravenous analgesic administration for 10 (intravenous group). Eleven patients received no nerve block (control group). We evaluated diclofenac sodium and pentazocine dosing, visual analog scale (VAS) scores, and perioperative complications in each group. VAS scoring was done immediately after surgery and 1 and 6 hours and 1, 2, 3, 7, and 14 days postoperatively.
Results: The doses of diclofenac sodium and pentazocine did not differ between groups. VAS scores immediately after surgery and at 1 and 6 hours after surgery were significantly lower in the single-injection and continuous-injection groups than in the suprascapular, intravenous, and control groups. VAS score at 1 day postoperatively was significantly lower in the continuous-injection group than in the other groups. One patient in the continuous group reported temporary paralysis of the fingers and drug solution leakage.
Conclusion: Interscalene nerve blocks yielded good pain relief for ARCR. Although continuous interscalene nerve block produced continuous pain relief, complications are a concern.

J Nippon Med Sch 2020; 87: 87-91

Keywords
Arthroscopic rotator cuff repair, Anesthesia, Interscalene brachial plexus block, Suprascapular nerve block, Intravenous administration of analgesic

Correspondence to
Satoshi Iwashita, Department of Orthopaedic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
iwashita@nms.ac.jp

Received, September 21, 2018
Accepted, December 12, 2019