Addition of Preoperative Ultrasound-Guided Suprascapular Nerve Block and Axillary Nerve Block to Parecoxib Is More Effective in Early Postoperative Pain Control After Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Study

Abstract

PurposeThe purpose of the study was to prospectively compare the pain intensity and patient-reported outcomes (PROs) following arthroscopic rotator cuff repair (ARCR) between patients who received ultrasound-guided suprascapular nerve block (SSNB) and axillary nerve block (ANB) as well as preincisional parecoxib and patients who received preincisional parecoxib only. MethodsSixty-one patients receiving ARCR between March 2020 and March 2021 were prospectively enrolled. They were randomly assigned to the peripheral nerve block group (group N, n=30) or control group (group C, n=31). Two patients from group C were excluded because of miscommunication. All patients were administered parecoxib 40 mg intravenously prior to induction of anesthesia. In group N, SSNB/ANB were performed after general anesthesia while no nerve block was performed in group C. The pain intensity was compared before the surgery, as well as immediately, 24 hours and 2 weeks after the surgery. PROs, including Oxford shoulder score, University of California-Los Angeles shoulder score and Single Assessment Numeric Evaluation score, were compared before and 6 months after the surgery. ResultsThe resting pain numerical rating scale (NRS) was significantly lower in group N (4.9 ± 3.1 vs. 7.6 ± 2.5, p<0.001) immediately after the surgery, but no difference was noted 24 hours after the surgery. The resting pain NRS 2 weeks after the surgery was significantly lower in group N (1.4 ± 1.6 vs. 2.7 ± 2.7, p=0.03), but the movement-evoked pain and night pain were similar. All PROs significantly improved 6 months after the surgery in both groups, but there was no difference between the 2 groups. ConclusionAddition of preoperative ultrasound-guided SSNB and ANB to parecoxib offered better resting pain control immediately and 2 weeks after ARCR, but there was no benefit for PROs 6 months after the surgery. Level of EvidenceLevel 2 prospective randomized controlled trial