Patient-Reported Outcomes After Arthroscopic Shoulder Surgery With Interscalene Brachial Plexus Nerve Block Using Liposomal Bupivacaine: A Prospective Observational Study

Abstract

Background: Interscalene brachial plexus nerve blocks (ISBPNBs) are commonly used to mitigate postsurgical pain after shoulder surgery.

Materials and methods: We performed a prospective observational study in 57 consecutive adult patients undergoing arthroscopic shoulder surgery with an ultrasound-guided ISBPNB using liposomal bupivacaine (LB; 133mg/10ml) mixed with 0.5% bupivacaine (10ml). All patients received prescriptions for 1000mg of oral acetaminophen and 10 5mg oxycodone tablets upon discharge.

Results: Post-discharge telephone surveys revealed that mean (standard deviation [SD]) patient-reported motor and sensory recovery times after surgery were 26.8 (3.2) and 34.0 (3.6) hours, respectively. The average (SD) visual analog scale pain score was 5.1 (3.1) at day two post-surgery. The estimated opioid utilization rate at day seven post-surgery was 21% of the prescribed opioid tablets.

Conclusions: Our real-world observational findings suggest that multimodal postsurgical pain control using single-shot, ultrasound-guided ISBPNB with LB and postsurgical acetaminophen provides favorable pain control and limited need for postsurgical opioid rescue for seven days after shoulder surgery.