Key result
Preoperative interscalene lidocaine blockade fails to reduce 24-hour oxycodone consumption versus postoperative blockade.
Why the study?
There were no clinical studies investigating the pre-emptive analgesic effects of interscalene brachial plexus block for shoulder surgery.
Does pre-emptive interscalene brachial plexus blockade reduce postoperative oxycodone consumption and pain in patients undergoing elective shoulder surgery?
Population
60 ASA I-II patients undergoing elective shoulder surgery for rotator cuff syndrome
Comparison
Preoperative interscalene brachial plexus block vs postoperative block vs no local anaesthesia
Design
Prospective randomized controlled trial with blinded recovery and ward personnel
Follow-up
24 hours
Authors
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Hypothesis-generating for pre-emptive analgesia; leaves open efficacy confirmation in larger randomized trials before any practice change.
RCT (n=60)
Blinded (recovery and ward personnel)
Randomized
No
Does pre-emptive interscalene brachial plexus blockade reduce postoperative oxycodone consumption and pain in patients undergoing elective shoulder surgery?
Absolute Event Rate: 62.3% vs 51%
p-value: p=NS
Pre-emptive interscalene brachial plexus blockade with lidocaine does not reduce postoperative pain or opioid consumption compared to postoperative blockade in patients undergoing shoulder surgery.
Haltiavaara et al. (2003) conducted an RCT in Elective surgery of the shoulder (rotator cuff syndrome) (n=60). Preoperative interscalene brachial plexus blockade with lidocaine vs. Postoperative blockade (Group 2) or no blockade (Group 3) was evaluated on Cumulative oxycodone consumption at 24 hours (p=NS). Preoperative interscalene brachial plexus blockade with lidocaine did not significantly reduce 24-hour cumulative oxycodone consumption (62.3 vs 51.0 mg) compared to postoperative blockade.
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