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Multimodal approach to postoperative pain control in patients undergoing rotator cuff repair

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Author(s)
Chul-Hyun ChoKwang-Soon SongByung-Woo MinKyung-Jae LeeEunyoung HaYong-Chul LeeYoung-Kuk Lee
Keimyung Author(s)
Cho, Chul HyunSong, Kwang SoonMin, Byung WooLee, Kyung JaeHa, Eun YoungLee, Yong Cheol
Department
Dept. of Orthopedic Surgery (정형외과학)
Dept. of Biochemistry (생화학)
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
Knee Surgery, Sports Traumatology, Arthroscopy
Issued Date
2011
Volume
19
Issue
10
Keyword
Rotator cuff repairPostoperative pain controlMultimodal approach
Abstract
Purpose:

This prospective study was undertaken to compare the effectiveness and safety of a multimodal pain control protocol with those of intravenous patient-controlled analgesia in rotator cuff repair.


Methods:

Seventy patients scheduled for rotator cuff repair were randomized to either a multimodal pain control group (group 1, 40 patients) or an intravenous patient-controlled analgesia group (group 2, 30 patients). We compared these two groups with respect to level of pain before surgery to the fifth postoperative day, duration of postoperative rehabilitation, consumption of additional analgesics, and adverse effects.


Results:

Mean visual analogue scale scores immediately after surgery (day 0) and on postoperative days 1–5 were 6.9, 5.5, 4.3, 3.3, 3.0, and 2.6 in group 1 and 7.8, 5.9, 4.4, 4.7, 4.3, and 3.7 in group 2. Pain relief was significantly better in group 1 on days 0, 3, 4, and 5 (P = 0.026, 0.006, 0.010, and 0.009, respectively). Furthermore, functional recovery occurred earlier in group 1. No significant differences were observed between the two groups with respect to nausea, vomiting, urinary retention, and headache (n.s.), but group 1 was found to be significantly less likely to experience dizziness or urticaria (P = 0.007, 0.017, respectively). One other significant difference was observed: 1 patient (2.5%) in group 1 and 6 patients (20%) in group 2 discontinued regimen because of medication-related adverse effects (P = 0.016).


Conclusion:

The multimodal pain control protocol was found to offer more effective postoperative pain control with fewer adverse effects than intravenous patient-controlled analgesia. However, achieving adequate pain control within the first 48 h of surgery remains challenging, and thus, the developments of more effective and safer multimodal pain control protocols are required.
Keimyung Author(s)(Kor)
조철현
송광순
민병우
이경재
하은영
이용철
Publisher
School of Medicine
Citation
Chul-Hyun Cho et al. (2011). Multimodal approach to postoperative pain control in patients undergoing rotator cuff repair. Knee Surgery, Sports Traumatology, Arthroscopy, 19(10), 1744–1748. doi: 10.1007/s00167-010-1294-y
Type
Article
ISSN
0942-2056
Source
https://link.springer.com/article/10.1007%2Fs00167-010-1294-y
DOI
10.1007/s00167-010-1294-y
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34319
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
1. School of Medicine (의과대학) > Dept. of Biochemistry (생화학)
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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