Prediction Of Post Operative Pain Following Arthroscopic Shoulder Surgery

PREDICTION OF POST OPERATIVE PAIN FOLLOWING ARTHROSCOPIC SHOULDER SURGERY

Following arthroscopic shoulder surgery a small but significant number of people suffer severe postoperative pain.

This study aims to predict which patients are at risk of developing severe post operative pain so that they may be targeted with a more aggressive post operative pain regimen.

Patients presenting for elective (day case) arthroscopic shoulder surgery for either Arthroscopic Subacromial Decompression (ASD Group) or Rotator Cuff Repair (RCR Group) are recruited. Using a Cefar PainMatcher, a pain and sensory threshold assessment tool, consenting patients will have their preoperative pain thresholds recorded. The patients will then have a standard anaesthetic administered with TIVA (propofol/remifentanil) and either a subacromial injection (ASD Group) or interscalene block (RCR Group). Four days following surgery a telephone questionnaire will be completed by the patients recording their worst pain score since surgery.

Inclusion Criteria:

• All patients aged 18 years or older able to give informed consent undergoing arthroscopic shoulder surgery at NHS Fife (ASD or rotator cuff repair)

Exclusion Criteria:

• Unable to give informed consent
• Allergy to remifentanil, propofol or levobupivacaine.
• Absence of contralateral arm (thumb/fingers)
• Documented sensory abnormality (e.g. peripheral neuropathy)
• Those not consenting to subacromial injection or interscalene block intraopertively (part of routine management after surgery).
• Psychiatric disease (documented history in Hospital notes or GP referral summary)
• Drug or alcohol misuse (suspicion of or documented)
• No telephone or unable to communicate in English (no interpreter service available)