Effects of different local anesthetics for brachial plexus block on rebound pain after arthroscopic shoulder surger-y
ZHAO Yu-lin
YAN Zhang-jun
HUANG Xiao-lin
YANG Ren
ZHAO Gang
SHAO Ru-yi
JIN Fan
Abstract：Objective To evaluate the effects of liposomal bupivacaine(LB)and ropivacaine(R)for brachial plexus block on rebound pain in patients undergoing arthroscopic shoulder surgery.Methods Ninety patients scheduled for elective arthroscopic rotator cuff repair were randomly divided into LB group(n=45)and R group(n=45).Prior to general anesthesia,ultrasound-guided interscalene brachial plexus block was performed.The LB group received 10 mL liposomal bupivacaine(133 mg)plus 10 mL saline,and the R group received 10 mL ropivacaine(75 mg)plus 10 mL sa-line.Outcomes included incidence of rebound pain,time to first analgesic request,numerical rating scale(NRS)pain scores at 6 h(T1),12 h(T2),18h(T3),24h(T4),and 48 h(T5)after surgery,number of effective patient-con-trolled intravenous analgesia(PCIA)presses within 48 h,requirement of rescue analgesia,and postoperative complica-tions.Results The incidence of rebound pain was significantly lower in the LB group(20.5％)compared with the R group(47.6％)(P=0.008).The median time to first analgesia was longer in the LB group[43.0(18.0,48.0)h]than in the R group[12.0(7.5,18.0)h](P＜0.001).At 12 h,18 h,and 24 h postoperatively,both resting and movement NRS scores were lower in the LB group(P＜0.05).The number of PCIA presses at 0-24 h and 24-48 h was significantly lower in the LB group(P＜0.001 and P=0.010,respectively).Rescue analgesia at 24 h was required in fewer patients in the LB group(9.1％)compared with the R group(38.1％)(P=0.001).No significant differences were observed in other NRS scores or incidence of complications between groups(P＞0.05).Conclusion Liposomal bupivacaine for brachial plexus block can effectively reduce the incidence of rebound pain,prolong analgesic duration,and improve postoperative pain outcomes in patients undergoing arthroscopic shoulder surgery.
Keywords：Nerve blocklocal anesthesiapostoperative painliposomal bupivacaineshoulder arthroscopy
Publication Date：2025-10-15
Online Publishing Date：2025-11-28(First online date of this platform, not the publication date of the document)
Pages：7( 1489-1495 )