Review compares analgesic interventions after shoulder surgery (Nerve blocks are best)

Medical Xpress / HealthDay / 49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting ^ | April 8, 2024 | Elana Gotkine / Sheila Gokul, M.D.

[ConservativeMind]

The average pain trajectories after shoulder surgery vary with different analgesic interventions, according to research.

Sheila Gokul, M.D. and colleagues examined average pain trajectories with different analgesic interventions for 48 hours after shoulder surgery in a systematic review of randomized controlled trials and cohort studies assessing pain scores according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data were included from 74 studies, with 4,676 patients. The researchers identified three main treatment groups: continuous nerve block (CNB), single shot nerve block (SSNB), and conventional analgesia (CA). At 12 hours postoperatively after all shoulder surgeries, pain scores differed significantly in the presence of CNB, SSNB, and CA (mean, 1.04, 2.39, and 4.52, respectively).

At both 24 and 48 hours, patients with CNB reported very low pain scores on average (1.84 and 1.51, respectively). On direct comparison of CNB and SSNB, there was no significant difference observed between the groups in immediate postoperative pain (1.55 and 1.49); at 12, 24, and 48 hours, the CNB group had significantly lower mean pain scores (1.04 versus 2.39, 1.84 versus 3.05, and 1.51 versus 2.62, respectively).

"In this systematic summative review, we observed the average pain trajectories after shoulder surgery and found that pain was significantly different at most time points in the 48 hours after surgery between conventional therapy, SSNB, and CNB," the authors write.

[ConservativeMind]

Nerve blocks, especially the continuous approach, worked best.

[ConservativeMind]

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[31R1O]

It’s what I had. Didn’t feel a thing for a while. 3 days of narcotics then tylenol and nsaids. No complications.

[Reddy]

So using nerve blocks instead of opioids post surgery should help avoid addiction? Maybe will also help alleviate the war against opioids.

[1756-L85E]

My shoulder surgery hurt like hell for 3 YEARS

[Bratch]

Just went thru two rounds of surgery on my arms for both cubital and carpal tunnel syndrome.

The procedures included a nerve block of the arm which resulted in minimal pain during recovery. I was quite pleased with the outcome.