Journal of clinical anesthesia · 2025
The analgesic efficacy of subacromial bursa block for arthroscopic shoulder surgery: A systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Patel N, Brull R, Yung E M, Hussain N, Got T, Dwyer T, Urman R, Abdallah F W
Аннотация
BACKGROUND: The subacromial-subdeltoid bursa block (SBB) has been reported to provide postoperative pain relief following arthroscopic shoulder surgery, although evidence of its efficacy remains unclear. This meta-analysis evaluates the analgesia efficacy of adding SBB to systemic analgesia compared to systemic analgesia alone.
METHODS: Literature was searched for randomized controlled trials comparing SBB and systemic analgesia to systemic analgesia alone (Control). Post-operative analgesic consumption, measured in oral morphine equivalents over the first 24 h post-operatively, was the primary outcome. Secondary outcomes included pain scores up to 48 h post-operatively, patient satisfaction, functional outcomes, opioid-related side effects, and block-related complications.
RESULTS: Fifteen trials (679 patients) were included. Compared to systemic analgesia alone, the addition of single injection SBB reduced 24-h post-operative morphine consumption by 58.98 mg [-100.14, -17.81] (p = 0.005) over the first 24 h. SBB also reduced pain scores up to 18 h post-operatively. In contrast, continuous SBB did not reduce opioid consumption, with a mean difference of -40.36 mg [-81.77, 1.06] (p = 0.06). Additionally, continuous SBB did not improve pain control at any time point. The addition of SBB did not yield any differences in patient satisfaction, functional scores, or adverse events compared to systemic analgesia alone.
CONCLUSIONS: Compared to systemic analgesia alone, this meta-analysis suggests that for arthroscopic shoulder surgery, the addition of single-injection SBB can reduce postoperative pain and opioid consumption for up to 18 and 24 h, respectively. In contrast, continuous SBB does not seem to improve any of the analgesic outcomes. Single-injection SBB may be considered an effective analgesic technique for arthroscopic shoulder surgery when proximal brachial plexus blockade is contraindicated or otherwise undesirable.
METHODS: Literature was searched for randomized controlled trials comparing SBB and systemic analgesia to systemic analgesia alone (Control). Post-operative analgesic consumption, measured in oral morphine equivalents over the first 24 h post-operatively, was the primary outcome. Secondary outcomes included pain scores up to 48 h post-operatively, patient satisfaction, functional outcomes, opioid-related side effects, and block-related complications.
RESULTS: Fifteen trials (679 patients) were included. Compared to systemic analgesia alone, the addition of single injection SBB reduced 24-h post-operative morphine consumption by 58.98 mg [-100.14, -17.81] (p = 0.005) over the first 24 h. SBB also reduced pain scores up to 18 h post-operatively. In contrast, continuous SBB did not reduce opioid consumption, with a mean difference of -40.36 mg [-81.77, 1.06] (p = 0.06). Additionally, continuous SBB did not improve pain control at any time point. The addition of SBB did not yield any differences in patient satisfaction, functional scores, or adverse events compared to systemic analgesia alone.
CONCLUSIONS: Compared to systemic analgesia alone, this meta-analysis suggests that for arthroscopic shoulder surgery, the addition of single-injection SBB can reduce postoperative pain and opioid consumption for up to 18 and 24 h, respectively. In contrast, continuous SBB does not seem to improve any of the analgesic outcomes. Single-injection SBB may be considered an effective analgesic technique for arthroscopic shoulder surgery when proximal brachial plexus blockade is contraindicated or otherwise undesirable.