Yoon Seong-Meen, Lee Aeryoung, Choi Sungwook
Department of Orthopedic Surgery, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea.
J Clin Med. 2025 May 30;14(11):3882. doi: 10.3390/jcm14113882.
This retrospective cohort study compared the outcomes (postoperative pain, morphine consumption, sleep disturbance, and function) of patients undergoing arthroscopic rotator cuff repair involving either continuous interscalene block (CISB group) or single-injection interscalene block with intravenous dexmedetomidine (SISB group) analgesia. : This study included 61 patients, aged 59-71 years, who underwent elective arthroscopic rotator cuff repair and for whom complete electronic health records were available. Patients in the SISB group received a single-injection nerve block plus intraoperative intravenous dexmedetomidine and postoperative patient-controlled analgesia (PCA; morphine and dexmedetomidine; = 33). Patients in the CISB group received continuous nerve block and morphine PCA ( = 28). Patient sleep disturbances, pain, total morphine consumption, and functional outcomes were evaluated postoperatively. : During the first 36 h postoperatively, there were no significant differences in the measured effects for patients in the two groups. Similarly, there were no significant differences in functional outcomes. However, patients in the SISB group had a significantly lower median morphine consumption total (18 mg) than those in the CISB group (24 mg; < 0.001). : Patients in the SISB group demonstrated significantly lower median morphine consumption than those in the CISB group; however, the postoperative pain, frequency of sleep disturbances, nausea, and functional outcomes did not show statistically significant differences. The reduced morphine consumption associated with the SISB group, compared with the CISB group, suggests that this analgesic protocol may result in fewer opioid-related effects following arthroscopic rotator cuff repair.
这项回顾性队列研究比较了接受关节镜下肩袖修复术的患者在连续肌间沟阻滞(连续肌间沟阻滞组)或单次注射肌间沟阻滞联合静脉注射右美托咪定(单次注射肌间沟阻滞组)镇痛情况下的结局(术后疼痛、吗啡用量、睡眠障碍和功能)。本研究纳入了61例年龄在59至71岁之间、接受择期关节镜下肩袖修复术且有完整电子健康记录的患者。单次注射肌间沟阻滞组的患者接受单次注射神经阻滞加术中静脉注射右美托咪定和术后患者自控镇痛(PCA;吗啡和右美托咪定;n = 33)。连续肌间沟阻滞组的患者接受连续神经阻滞和吗啡PCA(n = 28)。术后评估患者的睡眠障碍、疼痛、吗啡总用量和功能结局。在术后的前36小时内,两组患者的测量效应无显著差异。同样,功能结局也无显著差异。然而,单次注射肌间沟阻滞组患者的吗啡总用量中位数(18毫克)显著低于连续肌间沟阻滞组(24毫克;P < 0.001)。单次注射肌间沟阻滞组患者的吗啡用量中位数显著低于连续肌间沟阻滞组;然而,术后疼痛、睡眠障碍频率、恶心和功能结局并无统计学上的显著差异。与连续肌间沟阻滞组相比,单次注射肌间沟阻滞组吗啡用量减少,这表明该镇痛方案可能会减少关节镜下肩袖修复术后与阿片类药物相关的效应。