Riassunto dello studio

Seventy-two patients undergoing total shoulder arthroplasty were randomized to receive a continuous interscalene catheter with bupivacaine (n=24), a single-shot interscalene block with bupivacaine and dexamethasone plus saline infusion (n=24), or a single-shot interscalene block with liposomal bupivacaine plus saline infusion (n=24). The primary outcome was the worst numeric rating scale (NRS) pain score assessed at PACU arrival and at 6, 12, 24, and 36 hours postoperatively. Secondary outcomes included time to first analgesic request, intraoperative and inpatient opioid use, duration of analgesia, motor and sensory recovery, functional outcomes (PROMIS), and complications. Outcomes were assessed up to 36 hours postoperatively. Overall, the results of the study revealed no statistically significant differences in pain scores, opioid use, or functional recovery between the three groups. The study concluded that single-injection interscalene blocks with either liposomal bupivacaine or dexamethasone provide comparable analgesia to a continuous interscalene catheter, suggesting either can be considered depending on clinical context and resource availability.