Comparative Effectiveness of Combined Patient-Controlled Analgesia (PCA) and Intra-Operative Suprascapular Nerve Block (I-SSNB) Versus Stand-Alone Intra-Operative Suprascapular Nerve Block on Acute Post-Arthroscopy Pain: A Retrospective Cohort Study

Intravenous patient-controlled analgesia (IV-PCA) is commonly used for pain control following arthroscopic rotator cuff repair (ARCR), but its use is limited by adverse effects such as nausea and vomiting. The suprascapular nerve block (SSNB) has emerged as an effective regional analgesic alternative. This retrospective cohort study aimed to compare the analgesic efficacy and safety of intra-operative SSNB (I-SSNB) alone versus I-SSNB combined with fentanyl-based IV-PCA. Forty patients undergoing ARCR under general anesthesia were allocated to either I-SSNB alone (n = 20) or I-SSNB + IV-PCA (n = 20). Pain scores were assessed using a 0–10 visual analogue scale from the recovery room to postoperative day 3, along with opioid consumption and adverse events. No statistically significant differences in pain scores or opioid use were observed between groups. However, adverse effects such as nausea and vomiting occurred only in the I-SSNB + IV-PCA group. These findings suggest that I-SSNB alone provides comparable analgesia to the combination regimen, while avoiding IV-PCA-related side effects. Thus, IV-PCA may not be necessary when I-SSNB is employed for postoperative analgesia following ARCR.