• Nam Su Cho, Jeong Han Ha, and Yong Girl Rhee.
• Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
• Am J Sports Med. 2007 Jan 1;35(1):75-9.

BackgroundNo study has compared pain control results between patient-controlled subacromial infusion and intravenous injection after arthroscopic shoulder surgery.HypothesisSubacromial infusion of analgesics are more effective in pain alleviation than intravenous injection.Study DesignRandomized controlled clinical trial; Level of evidence, 2.MethodsThe authors prospectively analyzed 40 cases of arthroscopic rotator cuff repair that received patient-controlled analgesia. They divided the 40 cases into 2 groups: subacromial infusion group with 0.5% bupivacaine (group 1, 20 cases) and intravenous injection group with fentanyl and ketorolac tromethamine (group 2, 20 cases). The visual analog scale was used to record the patient's level of pain every 12 hours until postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia.ResultsThe mean preoperative visual analog scale score during motions was 6.8 in group 1 and 5.8 in group 2. The immediate postoperative visual analog scale score was 7.6 and 7.4, respectively, for each group. At postoperative time periods, most of the scores of subacromial infusion at rest and during motions were lower than those of intravenous injection, but significant differences were not found between groups 1 and 2.ConclusionPatient-controlled analgesia after arthroscopic rotator cuff repair showed that both subacromial infusion of bupivacaine and intravenous injection of fentanyl and ketorolac tromethamine were equally effective and clinically equivalent pain control methods.

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