• Tobias Winkler, Arnold J Suda, Radu V Dumitrescu, Oswald Pinggera, Georg Weber, Gerald Loho, Barbara Schneider, and Christian Wurnig.
• Center of Musculoskeletal Surgery, Department of Orthopaedics, Charité-Universitätsmedizin Berlin, Berlin, Germany. tobias.winkler@charite.de
• J Shoulder Elbow Surg. 2009 Jul 1;18(4):566-72.

IntroductionInterscalene and subacromial infusion of local anesthetics have both been shown to be effective in alleviating pain after shoulder arthroscopy. We performed a prospective randomized clinical trial in which both methods were compared in patients after acromioplasty.MethodsForty patients received a subacromial (n = 20) or an interscalene (n = 20) continuous infusion of 2% ropivacaine (2 mL/h) after arthroscopic acromioplasty. Visual analog scale pain scores, additional medication requirements, and side effects were evaluated for 43 hours. The incidence of night pain was recorded.ResultsCompared with the subacromial infusion, the continuous interscalene infusion of ropivacaine in the operated-on shoulder resulted in significantly reduced visual analog scale pain scores measured during rest, and also during exercise at 8 and 12 hours after surgery. The incidence of night pain was significantly lower in the interscalene group (P = .018).ConclusionA continuous subacromial infusion of 0.2% ropivacaine (2 mL/h) is inferior to continuous interscalene infusion, particularly during the first 12 hours, but could be an alternative in patients with contraindications of interscalene anesthesia or when acromioplasty is performed as an outpatient procedure.

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