hydrocodone and Shoulder-Impingement-Syndrome

The aim of the study was to evaluate the long-term effect of the use of a pain pump after arthroscopic subacromial decompression.. This prospective, randomized study included 50 patients: 25 patients had a 24-hour pain pump with 0.375% ropivacaine infusion and a continuous rate of 5 mL/h in the subacromial space after arthroscopic subacromial decompression, and 25 patients did not. Rehabilitation was similar in both groups. Evaluation methods were clinical examination, radiographic evaluation, and isometric elevation strength measurements, as well as the University of California, Los Angeles and Constant shoulder scores. All the operations were done by 1 experienced orthopaedic surgeon, and all the evaluations at follow-up were done by 1 independent, blinded examiner. There were no differences between the study groups preoperatively. Of the patients, 47 (94%) were available at a minimum follow-up of 2 years (range, 24 to 32 months).. Concerning the duration of sick leave (P = .053) and ability to return to work (P = .321), the group differences were not statistically significant. At follow-up, the shoulder scores (University of California, Los Angeles and Constant) were significantly better than preoperatively (P < .001) in both groups, although no differences were found between the groups. The isometric elevation strengths of the operated shoulders were equally good in both groups (P = .976) as well, and no significant differences were observed between the operated shoulders and nonoperated shoulders at follow-up.. According to this study, the use of a pain pump after arthroscopic subacromial decompression did not have any long-term effects on the patients' recovery, return to work, or final result at the minimum 2-year follow-up. The results were significantly better at follow-up than preoperatively in both groups.. Level II, prospective, randomized therapeutic study lacking statistical significance and narrow confidence intervals.

Topics: Adult; Amides; Analgesics, Opioid; Decompression, Surgical; Female; Follow-Up Studies; Humans; Hydrocodone; Infusion Pumps, Implantable; Male; Middle Aged; Muscle Strength; Pain Measurement; Pain, Postoperative; Prospective Studies; Ropivacaine; Shoulder Dislocation; Shoulder Impingement Syndrome; Treatment Outcome; Weight-Bearing

To evaluate the efficacy of a subacromial patient-controlled analgesia (PCA) infusion of 0.2% ropivacaine versus saline for postoperative pain control following arthroscopic shoulder surgery.. Double-blind prospective randomized study.. A prospective, randomized double-blind study was performed on a consecutive group of 24 patients. All patients had arthroscopic subacromial decompression. Ropivacaine was chosen as the study drug due to the association of cardiac toxicity with the use of bupivacaine. The surgeon, anesthesiologist, and the operating room staff were blinded to the randomization. Immediately before surgery, the pharmacy staff randomized the type of drug infusion. Patients were asked to record their pain score using a visual analog scale (VAS) along with the amount of hydrocodone consumption for the first 2 days after surgery.. Nineteen patients completed the study. Ten patients received a subacromial infusion of 0.2% ropivacaine at 5 mL per hour with a bolus dose of 2 mL at a 15-minute lockout period via a microjet PCA pump (group I). Nine patients received saline in the same experimental conditions (group II). The use of a PCA ropivacaine infusion (group I) resulted in a significant reduction of postoperative pain by 34% as measured by VAS scale (P <.05), but no changes in the amount of hydrocodone consumption.. The use of subacromial 0.2% ropivacaine PCA infusion provided effective postoperative pain control.. Level I.

Topics: Acetaminophen; Administration, Oral; Adult; Aged; Ambulatory Surgical Procedures; Amides; Analgesia, Patient-Controlled; Analgesics, Non-Narcotic; Analgesics, Opioid; Arthroscopy; Decompression, Surgical; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Hydrocodone; Male; Middle Aged; Pain Measurement; Prospective Studies; Ropivacaine; Shoulder Impingement Syndrome; Treatment Outcome