Does the use of periarticular anesthetic cocktail provide adequate pain control following shoulder arthroplasty?

Authors

Elizabeth A. Klag, Henry Ford HealthFollow
Kelechi R. Okoroha, Henry Ford HealthFollow
Noah A. Kuhlmann, Henry Ford HealthFollow
Gabriel Sheena, Henry Ford Health
Chaoyang Chen, Henry Ford HealthFollow
Stephanie J. Muh, Henry Ford HealthFollow

Recommended Citation

Klag EA, Okoroha KR, Kuhlmann NA, Sheena G, Chen C, and Muh SJ. Does the use of periarticular anesthetic cocktail provide adequate pain control following shoulder arthroplasty? Shoulder Elbow 2021; 13(5):502-508.

Document Type

Article

Publication Date

10-1-2021

Publication Title

Shoulder Elbow

Abstract

Background: Interscalene nerve block and liposomal bupivacaine have been found to provide adequate pain control following shoulder arthroplasty. We hypothesized that local infiltration of a periarticular cocktail would provide equivalent pain control compared to interscalene nerve block and liposomal bupivacaine.

Methods: Eighty-seven patients undergoing primary shoulder arthroplasty were treated with local infiltration of a periarticular cocktail (200 mg of 0.5% ropivacaine, 1 mg epinephrine, and 30 mg ketorolac), local infiltration of liposomal bupivacaine, or preoperative interscalene nerve block. The outcomes of the study were postoperative visual analog scale scores, opioid consumption, length of stay, and complications.

Results: A total of 30 patients receiving local infiltration of a periarticular cocktail, 26 receiving liposomal bupivacaine, and 31 receiving interscalene nerve block were included in the study. Patients who received local infiltration of a periarticular cocktail had a significantly lower mean visual analog scale when compared to interscalene nerve block and liposomal bupivacaine on postoperative day 0 (2.5 versus 4.0 versus 4.8, P = 0.001 and P < 0.001). Pain scores between postoperative day 0-3 were lower in patients who received local infiltration of a periarticular cocktail, but not significantly. Patients who received local infiltration of a periarticular cocktail required significantly less opioids than the interscalene nerve block group on postoperative day 0 (P < 0.001).

Discussion: A decrease in early postoperative pain and opioid consumption was found with local infiltration of a periarticular cocktail when compared with interscalene nerve block and liposomal bupivacaine after shoulder arthroplasty.

PubMed ID

34659483

Volume

13

Issue

5

First Page

502

Last Page

508