Post-operative pain control in arthroscopic rotator cuff repairs: a prospective, double-blinded, randomized controlled trial comparing interscalene catheters and single-shot blocks

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Background: Post-operative pain following arthroscopic rotator cuff repair is challenging. Peripheral nerve blocks are commonly used, but debate remains over single-shot versus continuous interscalene catheters. This trial compared early post-operative pain and opioid use with a single-shot block versus a continuous interscalene catheter. Methods: In this prospective, double-blinded randomized controlled trial, 45 patients undergoing arthroscopic rotator cuff repair received an interscalene catheter with an initial single-shot block. They were randomized to either a patient-controlled infusion of normal saline (control, n = 22) or low-dose anesthetic (treatment, n = 23). Visual analogue scale for pain severity (VAS-S) and frequency (VAS-F) were assessed pre-operatively, daily for the first post-operative week, and at 2, 6, and 12 weeks. Opioid consumption was recorded for one week post-operatively. Functional outcomes were measured using the Constant and Western Ontario Rotator Cuff scores, and satisfaction with the surgery was assessed at 12 weeks. Results: = .653) or satisfaction (treatment: 82%, control: 91%) was observed. Conclusion: Continuous interscalene catheters improved early post-operative pain without reducing opioid use. Despite these findings, careful consideration of patient needs, cost-effectiveness, and the potential complications associated with catheter use should be acknowledged in the individual patient's pain management strategy.

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