Comparative Effectiveness of Continuous Intra-Operative Suprascapular Nerve Block (CI-SSNB) with and Without Intravenous Patient-Controlled Analgesia (IV-PCA) on Acute Post-Arthroscopy Pain: A Retrospective Cohort Study.

Background/

Objectives

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 continuous intra-operative suprascapular nerve block (CI-SSNB) alone versus CI-SSNB combined with fentanyl-based IV-PCA (CI-SSNB + IV-PCA).

Methods

A total of 40 patients undergoing ARCR under general anesthesia with a single-shot interscalene block (ISB) were allocated to either CI-SSNB alone (n = 20) or CI-SSNB + IV-PCA (n = 20). Pain scores were assessed using a 0-10 visual analog scale from 0 to 72 h postoperatively at predetermined intervals, along with opioid consumption and adverse events.

Results

At post-operative day 0 (POD 0, 10 p.m.), mean pain scores were 5.75 ± 2.59 in the CI-SSNB + IV-PCA group vs. 3.95 ± 3.00 in the CI-SSNB group (p = 0.050). The total number of rescue pethidine doses up to post-operative day 3 was 1.80 ± 2.02 vs. 0.95 ± 1.10, respectively (p = 0.108). However, adverse effects such as nausea and vomiting occurred only in the CI-SSNB + IV-PCA group.

Conclusions

CI-SSNB provides comparable analgesia to CI-SSNB + IV-PCA, while avoiding IV-PCA-related side effects, suggesting that IV-PCA may not be necessary when CI-SSNB is employed for post-operative analgesia following ARCR.