Volume 82, Issue 9 (December 2024)
Tehran Univ Med J 2024, 82(9): 685-692 |
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Hadavi S M R, Zahedi M, Kalani N, Asmarian N O, Sahraei R. During the first two weeks following shoulder labral repair between patients receiving interscalene block alone and those receiving interscalene block plus intravenous morphine. Tehran Univ Med J 2024; 82 (9) :685-692
URL: http://tumj.tums.ac.ir/article-1-13344-en.html
URL: http://tumj.tums.ac.ir/article-1-13344-en.html
Seyed Mohammad Reza Hadavi1 
, Maryam Zahedi2 , Navid Kalani3 , Naeimeh Ossadat Asmarian4 , Reza Sahraei *5
, Maryam Zahedi2 , Navid Kalani3 , Naeimeh Ossadat Asmarian4 , Reza Sahraei *5
1- Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
2- Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
4- Department of Biostatistics, Anesthesia and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 5- Department of Anesthesiology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
5- Department of Anesthesiology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. ,sahraeir1354@gmail.com
2- Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
4- Department of Biostatistics, Anesthesia and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 5- Department of Anesthesiology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
5- Department of Anesthesiology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. ,
Abstract: (904 Views)
Background: Shoulder labral repair surgery is associated with significant postoperative pain and restricted mobility. Inadequate pain management may lead to delayed rehabilitation, increased risk of chronic pain development, and higher opioid consumption. This study aimed to compare postoperative pain intensity during the first two weeks following shoulder labral repair between patients receiving interscalene block alone versus those receiving interscalene block combined with intravenous morphine.
Methods: In this randomized, double-blind, parallel-group clinical trial, 120 patients undergoing open rotator cuff repair at Chamran Hospital, Shiraz (June-December 2024) were allocated using balanced block randomization. Group 1 received preoperative interscalene block with 30 mL of 0.5% ropivacaine, while Group 2 received the same block plus intravenous morphine (1% mg/kg). Data analysis was performed using descriptive statistics such as mean and percentage and appropriate statistical tests such as Repeated measurement and Anova using SPSS software, version 21 (SPSS Inc., Chicago, IL, USA). The significance level was considered to be (P<0.05).
Results: Demographic characteristics (age, sex, weight, ASA class) showed no significant intergroup differences (p>0.05). Pain scores were significantly lower at all time points in the combination therapy group compared to the block-only group (p<0.05).
Conclusion: The results of the present study showed that the combination of interscalene block with morphine was significantly more effective in reducing pain after rotator cuff surgery than interscalene block alone. This finding suggests that the use of morphine as an additional analgesic can enhance the analgesic effects of interscalene block and provide better pain relief. The combination of these two methods may cause a positive interaction in pain relief and reduce the need for other medications, which consequently prevents the side effects caused by additional analgesic drugs, and patients who receive the combination of these two treatment methods experience greater comfort and better functional improvement. However, it is recommended that further studies focusing on the precise dosage and timing of drug combinations be conducted to obtain more precise results regarding the optimization of pain management after rotator cuff surgery. Also, examining the long-term effects of this treatment method could help to better understand its advantages and disadvantages.
Methods: In this randomized, double-blind, parallel-group clinical trial, 120 patients undergoing open rotator cuff repair at Chamran Hospital, Shiraz (June-December 2024) were allocated using balanced block randomization. Group 1 received preoperative interscalene block with 30 mL of 0.5% ropivacaine, while Group 2 received the same block plus intravenous morphine (1% mg/kg). Data analysis was performed using descriptive statistics such as mean and percentage and appropriate statistical tests such as Repeated measurement and Anova using SPSS software, version 21 (SPSS Inc., Chicago, IL, USA). The significance level was considered to be (P<0.05).
Results: Demographic characteristics (age, sex, weight, ASA class) showed no significant intergroup differences (p>0.05). Pain scores were significantly lower at all time points in the combination therapy group compared to the block-only group (p<0.05).
Conclusion: The results of the present study showed that the combination of interscalene block with morphine was significantly more effective in reducing pain after rotator cuff surgery than interscalene block alone. This finding suggests that the use of morphine as an additional analgesic can enhance the analgesic effects of interscalene block and provide better pain relief. The combination of these two methods may cause a positive interaction in pain relief and reduce the need for other medications, which consequently prevents the side effects caused by additional analgesic drugs, and patients who receive the combination of these two treatment methods experience greater comfort and better functional improvement. However, it is recommended that further studies focusing on the precise dosage and timing of drug combinations be conducted to obtain more precise results regarding the optimization of pain management after rotator cuff surgery. Also, examining the long-term effects of this treatment method could help to better understand its advantages and disadvantages.
Type of Study: Original Article |
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