Multimodal Analgesia for Shoulder Rotator Cuff Surgery Pain: The Role of Naldebain® and Ultrasound-Guided Peripheral Nerve Blocks Combination

Abstract

Multimodal analgesia (MMA) strategy is widely used for anesthesia and perioperative pain management. MMA provides continuous and satisfactory postoperative pain management, subsequently prevents patients from the development of chronic postsurgical pain (CPSP). We report a 55-year-old female patient with impingement syndrome and provide an MMA protocol for rotator cuff surgery with satisfactory pain management, which combines oral nonopioid analgesics, long-acting dinalbuphine sebacate (Naldebain ER Injection) and ultrasound-guided peripheral nerve blocks. This protocol modifies the timing of long-acting dinalbuphine sebacate injection, thus decreases dinalbuphine sebacate associated side effects. The ultrasound-guided nerve block provides enough time for long-acting dinalbuphine sebacate to reach the therapeutic level. Moreover, multiple oral analgesics act as preventive analgesia, which further enhances postoperative long-acting dinalbuphine sebacate analgesia. We suggest that this MMA protocol can be performed successfully in patients receiving shoulder surgery to provide good pain management and inhibits the consequent CPSP. We believe this MMA protocol may also be used in other types of surgery.