Tittle:
Secondary issues were to
Postoperative analgesia in ambulatory
arthroscopic shoulder surgery: Prospective
comparative study of inter-scalenic block
versus continuous injection by inter-
scalenic catheter
Background and Objectives
Arthroscopic shoulder surgery has grown
significantly over the past few years at the
expense of open-air surgery for some
shoulder surgery procedures. That trend
can be explained by the many benefits
offered by the arthroscopic
approach, especially in terms of early
postoperative pain reduction, sparing the
muscles of the shoulder gridle. The
management of pain is an important issue
as much as it conditions the functional
recovery.
Ambulatory care in arthroscopic shoulder
surgery has experienced an important
development through the improvement of
loco-regional anesthesia and more recently
with multimodal techniques associated
with conventional anesthetic products and
adjuvant products (uquillas ). The benefit
of continuous perineural infusions for pain
control after shoulder procedures is not
well established, on the other hand the
safety of the procedure has been
demonstrated
(CONCLUSION:
The use of CIBPB for 72 hr in patients
undergoing
major  ambulatory  shoulder surgery can
result in good analgesia with minimal
opioid requirement, cost savings and
possibly improvement in outcome
measures (nielsen 2003))
In this study, our aim was to compare the
efficacity on postoperative pain of a
continuous infra-scalenic block by
Naropeine over 3 days versus a single-
injection infra-scalenic block in
combination with dexamethasone (DXM)
after arthroscopic shoulder surgery
procedures.
determine/ compare the side effects
Hypothèse d’équivalence ?/ description
type de bloc ?
Material and methods.
We performed a non-
randomized, monocentric, mono-operator
prospective comparative study between
November 2014 and December 2015, in a
private hospital in France, including 39
consecutive patients undergoing surgery
for rotator cuff repair or subacromial
decompression (acromioplasty). The
patients with contraindication to outpatient
surgery were excluded. Written
informed consent was obtained from all
patients. Two groups were constituted.
Group 1 consisting of 19 patients, received
ambulatory care through hospitalization at
home (HAH) with the placement of a
catheter with Naropein diffuser (2mg / ml
5ml / hr)(BISDC) Over 3 days in
combination of bone analgesia included
Paracetamol + code and non-steroidal anti-
inflammatory drugs. The care was carried
out twice a day by a specialized team
which could be contacted by telephone 24
hours a day. Group 2, consisting of 20
patients, were treated as outpatients with
oral analgesics Paracetamol + code and
non-steroidal anti-inflammatory drugs.
The intensity of pain was measured several
times a day, using the visual analog scale
(VAS) during the first postoperative week.
Analgesic use and side effects or
complications were also collected. The
data were recovered during the first
postoperative consultation with the
surgeon at D15.
-Description de la technique des bloc/ pose de
-catheter ?
-Technique de randomisation
-description du soin de l’équipe d’HAD/
consistution de l’équipe d’HAD/
-CRITERE DE JUGEMENT PRINCIPAL ? EVA
moyenne  ? EVA à un Jour précis  ? lien avec la
consommation d’antalgiques supplémentaires  ?
-critères de jugement secondaire
 - Qui est chargé de la récolte des données  ?
le chirurgien  ? un investigateur externe ?
- Analyse statistique

Results.
Of 39 patients presenting for arthroscopic
shoulder surgery during the study, no
patients were lost to sight. There was no
significant difference between the two
groups during the first postoperative week
(p = 0.09). There was no difference in
analgesic use between the 2 groups. A
single complication was observed in the
HAH group requiring the catheter to be
placed on D1. No major drug side effects
were noted in either group.

Conclusion.
We did not find any significant difference
between the two groups in the evaluation
of postoperative pain as well as in the
consumption of analgesic per os.
Ambulatory care with the placement of a
catheter to the continuous diffusion to the
whole post-operative analgesia versus
techniques of multimodal anesthesia
simpler and less expensive to set up.
 39 patients presenting for
arthroscopic shoulder excluded:Contraindications
surgery to ambulatory surgery

Randomized at surgery conclusion

19 BISDC/ 20 BISI