| Joint range of motion after total shoulder arthroplasty with and without a continuous interscalene nerve block: a retrospective, case-control study. | |
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MedLine Citation:
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PMID: 16135346 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Although a continuous interscalene nerve block (CISB) has been shown to provide potent analgesia after major shoulder surgery, its potential effects on postoperative rehabilitation remain uninvestigated. Therefore, this retrospective case-control study was undertaken to determine the association between CISB and joint range-of-motion after total shoulder arthroplasty (TSA). METHODS: The medical records for patients who underwent TSA at our institution in the previous 3 years were examined. Each patient with a CISB (cases) was matched with a patient without a CISB (controls) for the following variables: age, gender, and TSA type (primary v revision). Data collected included maximum shoulder elevation and external rotation (primary endpoints), along with pre- and postoperative pain scores. RESULTS: Of 134 charts reviewed, 25 cases were matched with an equal number of controls. On postoperative day 1, patients with or without a CISB achieved a median (5th-95th percentiles) of 85% (51-100) and 33% (11-56) of their surgeon-defined goal for elevation (P = .048), respectively, and attained 100% (33-100) and 17% (-81-68) for external rotation (P < .001), respectively. The median numeric rating pain score (NRS) during shoulder movement for patients with CISB was 2.0 (0.0-8.7) versus 8.5 (1.8-10.0) for patients without CISB (P < .001). Least, median, and highest resting NRS for the 24 hours after surgery were 0.0 (0.0-5.8), 1.0 (0.0-6.4), and 3.0 (0.0-9.0) for patients with CISB, respectively, versus 2.0 (0.0-7.7), 6.0 (0.3-9.6), and 8.0 (0.0-10.0) for patients without CISB (P = .030, P < .001, and P < .001 between groups, respectively). CONCLUSIONS: The day after TSA, a CISB is associated with increased shoulder range of motion, most likely resulting from the potent analgesia these nerve blocks provide. |
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Authors:
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Brian M Ilfeld; Thomas W Wright; F Kayser Enneking; Timothy E Morey |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Regional anesthesia and pain medicine Volume: 30 ISSN: 1098-7339 ISO Abbreviation: Reg Anesth Pain Med Publication Date: 2005 Sep-Oct |
Date Detail:
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Created Date: 2005-09-01 Completed Date: 2006-02-07 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9804508 Medline TA: Reg Anesth Pain Med Country: United States |
Other Details:
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Languages: eng Pagination: 429-33 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, 1600 SW Archer Road, Gainesville, FL 32610-0254, USA. bilfeld@ufl.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Arthroplasty, Replacement / methods*, rehabilitation Case-Control Studies Female Humans Male Middle Aged Nerve Block / methods* Pain Measurement / methods Pain, Postoperative / prevention & control* Range of Motion, Articular / drug effects*, physiology Recovery of Function / drug effects Retrospective Studies Shoulder Joint / physiology, surgery* Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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