Intra-articular infiltration analgesia for arthroscopic shoulder surgery: a systematic review and meta-analysis

研究概要

Fifteen randomized controlled trials containing a total of 863 patients undergoing arthroscopic shoulder surgery were included in this meta-analysis comparing anesthesia via intra-articular infiltration (n=408) to interscalene brachial plexus block (n=162) or control (n=293). The primary outcome of interest was cumulative opioid consumption at 24 hours post-operation. Secondary outcomes of interest included post-operative pain, time to first analgesic requirement, incidence of nausea and vomiting, and patient satisfaction. Results revealed no significant difference in pooled cumulative opioid consumption at 24 hours between the infiltration and interscalene block groups (p=0.11), but a significant difference in favour of the infiltration group vs control (p<0.001) was observed. Pooled post-operative pain was significantly in favour of the infiltration group vs control at 0, 2, 4, 8 and 12 hours post-operation (p<0.05 for all). Moreover, pooled patient satisfaction was significantly in favour of the infiltration group vs control (p<0.001) group. However, pooled post-operative pain scores at 2, 4, and 24 hours post-operation, as well as patient satisfaction, were significantly in favour of the interscalene block group vs the infiltration group (p<0.05 for all).