A study has found that patients undergoing shoulder surgery who receive continuous nerve blocks (CNBs) experience less pain following surgery compared to those who receive single-shot nerve blocks (SSNBs) and continuous analgesia (CA).
Patients who receive shoulder surgery often experience significant pain in the first 48 hours after surgery. If these patients only receive conventional oral analgesics, they may need high levels of opioids to maintain pain control after surgery. Using regional nerve blocks can help to reduce the need for opioids. However, doctors at Brigham and Women’s Hospital in Boston, MA, wanted to better understand which regional blocks worked best at reducing pain, as well as the average pain trajectory, which could provide insight into the optimal timing for providing these blocks.
Researchers looked at 74 existing studies, representing 4,676 patients, who received one of the three treatments – CNB, SSNB, or CA. They found that the patients who had received CNBs reported lower pain scores at 24 and 48 hours after surgery. They specifically compared the two regional block interventions – CNB and SSNB – and found that during the immediate postoperative period, there was no significant differences in pain. However, at 12, 24, and 48 hours after surgery, the CNB patients reported lower scores.
The researchers noted that the average pain scores remained within the mild range in both of the regional block groups, so if CNB is either unavailable or contraindicated, “SSNB may still provide improved analgesia over non-regional pain management techniques in the early postoperative period,” the authors wrote in their summary abstract.
The research abstract, “Procedure-Specific Acute Pain Trajectories After Shoulder Surgery,” was selected as one of three Resident/Fellow Travel awards, and will be presented on March 23 at 1:45 pm PT, during the 49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting in San Diego, CA. The authors are Drs. Shelia Gokul, Fabian Stangl, Claire Xu, Joy Badaoui, Lalitha Sundararaman, Kristen Schreiber, and Philip Lirk.
ASRA Pain Medicine is a membership society of more than 5,000 health care professionals devoted to advancing evidence-based practice of pain medicine across the pain continuum, from acute pain to chronic pain. Our mission is to advance the science and practice of regional anesthesia and pain medicine to improve patient outcomes through research, education, and advocacy. Our vision is to relieve the global burden of pain. We are committed to integrity, innovation, inclusiveness, service, compassion, and wellness. Learn more at www.asra.com.
