
Pain Improvement Combining Cocktail therapy with Interscalene Block and SSN for Rotator Cuff Repairs
J Shoulder Elbow Surg. 2020 Jul;29(7):1310-1315One hundred and twenty-eight scheduled for an arthroscopic rotator cuff repair surgery were randomized equally to either receive a cocktail analgesic therapy combined with single-dose interscalene block and suprascapular nerve (SSN) block, or the single-dose interscalene block and SSN block alone. The outcome of interests included the incidence of adverse events (nausea, delayed wound healing, and infection), incidence of postoperative diclofenac suppositories and buprenorphine injections. As well, patients were evaluated for passive shoulder range of motion (ROM), the incidence of retear, and pain on a Visual Analogue Scale (VAS) at 4, 8, 16, 24, 48 hours post-operation. In all outcomes, no differences were observed between the 2 treatment arms with the exception of the incidence of diclofenac suppository use, shoulder range of motion in anterior elevation at 3 months post-operation, and VAS pain scores at 8, 16, and 24 hours which were significantly in favour of the cocktail analgesia group compared to the control group. Therefore, there is some clinical benefit to the addition of using a cocktail therapy combined with interscalene block and SSN.
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