Analysis of factors affecting acute pain after shoulder arthroscopy: a retrospective clinical study

Arthroscopic shoulder surgery is a minimally invasive treatment; however, patients still experience significant postoperative pain. This study aimed to identify factors related to acute pain after shoulder arthroscopy and guide pain management.

This study included 272 patients who underwent shoulder arthroscopic surgery at our hospital between January 2020 and August 2021. Blood samples for apolipoprotein measurement were collected on the day before surgery after an overnight fast. Pain was assessed using the VAS at 24 h after surgery as the primary endpoint. Patients were divided into two groups according to pain levels 24 h after surgery: mild pain (VAS ≤3) and moderate-to-severe pain (VAS > 3). Logistic regression was used to analyze the relationships between postoperative pain and age, sex, BMI, injury type, method of operation, nerve block, and apolipoprotein levels.

The majority of patients (71.32%, 194/272) had moderate- to severe postoperative pain. Analysis revealed significant differences between the two groups in surgical method (P = 0.009), injury type (P = 0.042), nerve block administration (P = 0.039), apolipoprotein A-I levels (P = 0.006), and apolipoprotein C (P = 0.046). Logistic regression analysis showed that postoperative pain was correlated with nerve block administration and apolipoprotein A-I levels.

The absence of nerve block and elevated apolipoprotein A-I levels were associated with more severe postoperative pain after shoulder arthroscopy. Therefore, the findings suggest that brachial plexus block may reduce postoperative pain. Patients with elevated ApoA-I may benefit from closer monitoring.