This study is a prospective, randomized, double-blind trial comparing patients who underwent arthroscopic rotator cuff repair and received an interscalene brachial plexus block (9 ml of 0.75% ropivacaine, 3 ml for each trunk) combined with suprascapular nerve block and axillary nerve block (each with 10 ml of 0.75% ropivacaine) versus those who received an interscalene brachial plexus block (9 ml of 0.75% ropivacaine, 3 ml for each trunk) combined with placebo suprascapular and axillary nerve blocks (each with 10 ml of 0.9% saline).

The study will compare subjective pain scores (VAS score) and patient satisfaction preoperatively and at 1, 3, 6, 12, 18, 24, 36, and 48 hours postoperatively. Additionally, 5 ml of venous blood will be collected preoperatively and at 1, 6, 12, 24, and 48 hours postoperatively to analyze and compare serum levels of cortisol, IL-6, IL-8, IL-1β, substance P, serotonin, β-endorphin, and norepinephrine.

Inclusion Criteria:

• a definite rotator cuff tear that needed repair seen on preoperative magnetic resonancce imaging (MRI)
• acceptance of arthroscopic surgery including rotator cuff repair
• age same as or more than 20 years
• acceptance of preemptive regional block and PCA, and blood testing

Exclusion Criteria:

• did not undergo arthroscopic rotator cuff repair
• stopped PCA before 48 hours postoperatively because of associated side effects
• a history of previous ipsilateral shoulder operation or fracture
• a concomitant neurologic disorder around the shoulder
• a failure of blood sampling including hemolysis, etc.

We can decide it after the termination of this study.

An independent nurse uses a random number generator and allocates paticipants into the two group. Participant, investigator, and outcome assessor are blinded of the allocation information.