Analgesia requirements after interscalene block for shoulder arthroscopy: the 5 days following surgery

Excellent initial post-operative analgesia for patients undergoing arthroscopic shoulder surgery can be provided with a single-shot interscalene brachial plexus block. However there have been concerns that when the block wears off, patients may experience pain and this may occur at home. Some investigators have advocated the use of continuous ambulatory local anaesthetic infusions following hospital discharge. We prospectively studied pain scores, analgesic requirements and satisfaction of patients at home in the first 5 days following arthroscopic shoulder surgery to see whether continuous infusion would be of benefit.

Fifteen percent of patients experienced severe pain at some time over the first 3 days, and this percentage decreased to 7% by day 5. However 97% of our patients were satisfied with their post-operative oral analgesia management and less than 5% contacted their GP for further analgesia issues. Over 80% of our patients required only simple analgesics following hospital discharge.

Post-operative continuous ambulatory local anaesthetic infusions may not be justified following this intermediate magnitude of surgery.