Liposomal bupivacaine reduces opiate consumption after rotator cuff repair in a randomized controlled trial

Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. The use of intraoperative anesthesia in conjunction with multimodal pharmacologic  strategies is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a combined field and suprascapular nerve block with liposomal bupivacaine (LB) in addition to an interscalene block would provide greater pain reli ef and a reduction in opiate consumption compared with an interscalene block alone.
Source: Journal of Shoulder and Elbow Surgery - Category: Orthopaedics Authors: Source Type: research

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BACKGROUND Ultrasound-guided interscalene block (ISB) is the reference technique for pain control after ambulatory upper limb surgery, but supraclavicular block (SCB) is an alternative. OBJECTIVES The aim of this study was to compare the efficacy of SCB vs. ISB in patients undergoing ambulatory arthroscopic rotator cuff repair (ARCR), with the hypothesis of noninferiority of SCB analgesia compared with ISB. DESIGN A randomised, single-blind, noninferiority study. SETTING Hôpital Privé Jean Mermoz, Centre Paul Santy, Lyon, France. PATIENTS Ambulatory ARCR patients. INTERVENTION Patients were ra...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research
Publication date: Available online 8 June 2019Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Ujjwal K. Debnath, Vivek Goel, Sahil Saini, Neev Trehan, Ravi TrehanAbstractBackground &purposeThe recent advances in anaesthesia and analgesia have significantly improved the early recovery and effective post-operative pain control in day care surgery e.g. shoulder; arthroscopic procedures. Adequate analgesia improves the early rehabilitation for a better outcome. We prospectively evaluated the post-operative pain relief following the two methods of analgesia i.e. regional Inter-scalene block (ISB) vs Intra-arti...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
CONCLUSION Paracetamol/metamizole and paracetamol/ibuprofen are equally effective in treatment of acute postoperative pain at home after ambulatory surgery with comparable patient satisfaction levels. TRIAL REGISTRATION European Union Clinical Trials Register 2015-003987-35.
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Postoperative pain Source Type: research
Surgery and pain pills used to go hand in hand. After all, you need a strong prescription pain medication to ensure you aren’t in pain after a procedure, right? Turns out not only is prescription pain medication not always needed, but often not advisable after surgery, because it can raise the risk of opioid addiction. As a result, surgeons today are rethinking post-surgical pain management strategies. And if you’re going under the knife, you should too. In the 1990s, the number of opioid prescriptions written for people undergoing surgery or experiencing pain conditions grew — and so did related problems...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Pain Management Surgery Source Type: blogs
CONCLUSIONS: Perioperative intravenous ketamine probably reduces postoperative analgesic consumption and pain intensity. Results were consistent in different operation types or timing of ketamine administration, with larger and smaller studies, and by higher and lower pain intensity. CNS adverse events were little different with ketamine or control. Perioperative intravenous ketamine probably reduces postoperative nausea and vomiting by a small extent, of arguable clinical relevance. PMID: 30570761 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Evaluation and management of hip pain in minimally arthritic patients presents a unique challenge due to the prevalence of labral tears and common extra-articular sources of pain in the asymptomatic population. The purpose of this prospective study is to evaluate the relationship between pain relief from intra-articular hip injection with anesthetic and post-operative patient reported outcome measures (PROMs) in patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) correction and labral repair.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Source Type: research
ConclusionsHip arthroscopy is a relatively new field, and clinical practice may vary among physicians based on the surgical expertise. In this study, hip arthroscopy experts agree with non-experts on most aspects of patient care. Surgical expertise was associated with performance of advanced techniques and recommendation of longer period of restricted weight bearing following performance of microfractures. This study highlights different care patterns that need to be investigated to determine which treatment results in improved patient care.Level of evidenceV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
CONCLUSION: ACCLR for acute dislocation of the ACJ is a useful surgical procedure that gives satisfactory clinical and radiologic outcomes on mid- and long-term follow-up. ACCLR can stabilize vertical instability of the ACJ. If instability in the horizontal direction remains, repair or reconstruction of the acromioclavicular ligament should be added to prevent osteoarthritic changes of the ACJ. PMID: 30135343 [PubMed - in process]
Source: Journal of Nippon Medical School - Category: Universities & Medical Training Authors: Tags: J Nippon Med Sch Source Type: research
Conclusion: ACB preserves quadriceps motor strength while providing analgesia comparable to FNB in patients undergoing ACLR. However, patient satisfaction score is better with FNB than ACB.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Authors: Divella M, Vetrugno L, Orso D, Langiano N, Bignami E, Bove T Abstract BACKGROUND: While interscalenic nerve block (INB) is still considered the 'gold standard' for shoulder arthroscopy, its postoperative analgesic effectiveness has recently been called into question. Meanwhile, in light of its high-quality postoperative pain relief, a renewed interest has emerged in suprascapular nerve block (SNB). The first aim of our study was to compare the postoperative analgesia effects of these two types of block at 2, 4 and 6 hours after surgery. We also assessed shoulder functional recovery over a six-month follow-...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
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