Multimodal analgesia for arthroscopic rotator cuff repair: a randomized, placebo-controlled, double-blind trial

Abstract

The aim of the study was to investigate whether a multimodal analgesia (MMA) protocol reduces postoperative pain and opioids consumption in patients undergoing arthroscopic rotator cuff repair. Fifty-four patients scheduled for arthroscopic rotator cuff repair were randomly assigned to either the MMA group or the control group. The primary outcome was visual analog scale (VAS) for pain. Secondary outcome measures included the time required for the VAS pain to reduce to that of a blood draw, (PCA) consumption, rescue morphine consumption, night awakening, and opioid-related side effects. The MMA group showed significantly less postoperative pain at postoperative 5h, and 9a.m. and 5p.m. at 4th postoperative day (P<0.001,=0.040, and 0.013, respectively). MMA also shortened the time for postoperative pain to reduce down to the blood draw pain level from 5days in the control group to 2days in the MMA group. MMA also significantly reduced PCA consumption for up to 24h postoperatively (P=0.038) and rescue morphine consumption during the first 6h and between 48 and 60h postoperatively (P=0.036 and 0.044, respectively). No significant differences were observed between the MMA and control groups with respect to side effects. The MMA protocol used in this study was found to reduce postoperative pain and opioid consumption during the acute postoperative period after arthroscopic rotator cuff repair without increasing side effects after arthroscopic rotator cuff repair.