Pain after shoulder arthroscopy: a prospective study on 231 cases.

Area of Science:

• Orthopedic Surgery
• Pain Management
• Anesthesiology

Background:

• Shoulder arthroscopy is commonly perceived as painful.
• Limited data exists on the progression and long-term impact of postoperative pain following this procedure.

Purpose of the Study:

• To describe the progression of postoperative pain after shoulder arthroscopy.
• To identify risk factors associated with increased pain.
• To analyze the long-term impact of pain on patients.

Main Methods:

• Prospective study of 231 patients undergoing arthroscopic shoulder surgery.
• Pain assessment using Visual Analog Scale (VAS), morphine intake, and satisfaction at multiple time points (D-1 to 1 year).
• Evaluation of different local anesthetic techniques (subacromial injection/catheter, intra-articular catheter, no complement) under general or interscalene block anesthesia.

Main Results:

• VAS pain scores remained below 4/10 throughout the study.
• Postoperative pain was initially lower than preoperative pain, with a notable 'pain bounce' on days 1 and 2.
• Rotator cuff repair was the most painful procedure in early postoperative days; work-related accidents were a significant risk factor for higher VAS and morphine intake.
• No correlation was found between immediate postoperative and 1-year VAS values.

Conclusions:

• Shoulder arthroscopy is associated with relatively low and long-lasting pain relief.
• A 'pain bounce' on day 1 necessitates careful management, especially in outpatient settings.
• Local anesthesia techniques are beneficial; however, the long-term efficacy of current pain relief protocols was not definitively demonstrated.