The Effect of Dexmedetomidine for Suprascapular Nerve Block With Axillary Nerve Block

The Effect of Dexmedetomidine for Suprascapular Nerve Block With Axillary Nerve Block on Plasma Cortisol and Pain-related Cytokines After Arthroscopic Rotator Cuff Repair: a Randomized Controlled Trial

Suprascapular nerve block (SSNB) is most commonly used for relieving postoperative pain of arthroscopic rotator cuff repair and it can be used in combination with axillary nerve block (ANB). Dexmedetomidine (DEX) is known as a type of alpha agonist which can elongate the duration of regional block. The aim of this study was to compare the results of dexmedetomidine combined with SSNB and ANB with SSNB and ANB alone on postoperative pain, satisfaction, and pain-related cytokines within the first 48 hours after arthroscopic rotator cuff repair.

Forty patients with rotator cuff tears who had undergone arthroscopic rotator cuff repair were enrolled in this single center, double-blinded randomized controlled trial study. Twenty patients were randomly allocated to group 1 and received ultrasound-guided SSNB and ANB using each mixture of 0.5 ml (50 μg) of DEX and 9.5 ml of 0.75% ropivacaine preemptively. The other 20 patients were allocated to group 2 and underwent ultrasound-guided SSNB and ANB alone using a mixture of 0.5 ml of normal saline and 9.5 ml of ropivacaine. The visual analog scale (VAS) for pain and patient satisfaction (SAT) scores were checked within 48 h postoperatively. The plasma interleukin (IL)-6, -8,-1β, cortisol, and serotonin levels were also measured within 48 h postoperatively.

Inclusion Criteria:

• defined rotator cuff tear on preoperative MRI, which indicated repair
• acceptable arthroscopic surgery, including rotator cuff repair
• patients >20 years old
• acceptable routine regional blocks and patient-controlled analgesia (PCA)

Exclusion Criteria:

• did not undergo arthroscopic rotator cuff repair
• stopped PCA before 48 h postoperatively due to side effects
• had a concomitant operation for a Bankart lesion
• had a history of shoulder operation or fracture
• had a concomitant neurological disorder around the shoulder
• underwent conversion to open surgery from the arthroscopy
• had contraindications for the routine regional blocks used in this study
• had an known allergy or hypersensitivity against ropivacaine or dexmedetomidine, including other amino-amide local anesthetics or α2-adrenoceptor agonists.