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Research

SUBACROMIAL LOCAL ANAESTHETIC VERSUS LANDMARK-GUIDED NERVE BLOCKS FOR POSTOPERATIVE PAIN RELIEF IN SHOULDER ARTHROSCOPIES

The British Orthopaedic Research Society (BORS) Annual Meeting 2020, held online, 7–8 September 2020.



Abstract

Abstract

Introduction

Local anaesthetic injections are regularly used for perioperative pain relief for shoulder arthroscopies. In our practice all shoulder arthroscopies were performed under general aneasthesia supplemented by perioperative subacromial local anaesthetic injections or landmark guided axillary nerve together with suprascapular nerve injections. We compared pain relief achieved with these two methods. We hypothesized that the selective nerve blocks would provide better post operative pain relief as described in literature.

Methods

We conducted a retrospective cohort study on two patient groups with 17 patients each. Group one patients received 20mls 50:50 mixture of 1% lignocaine and 0.5% chirocaine injections before and after start of procedure and group two patients received 20 mls of chirocaine around the axillary and suprascapular nerves. VAS scores were collected at 1 and 4 hours and analgesia taken during the first 24 hours was recorded.

Results

No significant difference in pain scores was noted but analgesia requirements in the nerve block group were higher.

Conclusion

Landmark guided nerve blocks did not show any advantage over subacromial local anaesthetic in our study. This is in contrast to published literature and we believe subacromial injections are more reliable and reproducible.

Declaration of Interest

(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.