{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T17:36:35Z","timestamp":1785000995049,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,5,1]],"date-time":"2011-05-01T00:00:00Z","timestamp":1304208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2011,5,1]],"date-time":"2011-05-01T00:00:00Z","timestamp":1304208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study's purpose was to determine the effectiveness of adding a preoperative interscalene brachial plexus block to standard postoperative management, including oral narcotics and a subacromial bupivacaine infusion pump, after arthroscopic shoulder surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>After performing a prospective power analysis and obtaining institutional board approval, we conducted a randomized placebo\u2010controlled trial of 53 patients separated into a preoperative interscalene brachial plexus group and a control group. Group 1 received an interscalene block with 30 mL of 0.5% ropivacaine. Group 2 received a placebo with 10 mL of saline solution. All patients postoperatively received an arthroscopically placed subacromial infusion pump catheter for 72 hours and oral narcotics. Pain scores on a visual analog scale (VAS) and narcotic pill use were recorded at 6, 12, 20, 32, 40, 52, 60, 72, and 80 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Preoperative pain scores between groups were not significant (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05). A statistically significant difference was found for decreased pain scores at 6 hours after discharge in patients receiving an interscalene block (\n                      <jats:italic>P<\/jats:italic>\n                      = .001) (VAS of 30.9 in group 1\n                      <jats:italic>v<\/jats:italic>\n                      61.8 in group 2). There was also a decrease in the number of narcotic pills taken at the 6\u2010hour time interval (\n                      <jats:italic>P<\/jats:italic>\n                      = .1) (0.6 pills\n                      <jats:italic>v<\/jats:italic>\n                      1.1 pills). Group 1 had a rebound phenomenon 20 hours after discharge. Pain scores spiked as the effects of the block wore off (\n                      <jats:italic>P<\/jats:italic>\n                      = .08) (net change in VAS score increase, 25.0\n                      <jats:italic>v<\/jats:italic>\n                      10.3). No other statistical or clinical differences were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of a preoperative interscalene block to a postoperative subacromial infusion pump provided significant improvement of pain control only at 6 hours after discharge. Twelve hours after discharge, this benefit had disappeared. A rebound phenomenon of increased pain at 20 hours was seen after the interscalene block had worn off. After 20 hours, no statistically significant or clinically applicable differences were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2011.01.003","type":"journal-article","created":{"date-parts":[[2011,4,19]],"date-time":"2011-04-19T17:27:47Z","timestamp":1303234067000},"page":"603-610","source":"Crossref","is-referenced-by-count":52,"title":["Efficacy of Augmenting a Subacromial Continuous\u2010Infusion Pump With a Preoperative Interscalene Block in Outpatient Arthroscopic Shoulder Surgery: A Prospective, Randomized, Blinded, and Placebo\u2010Controlled Study"],"prefix":"10.1002","volume":"27","author":[{"given":"James R.","family":"DeMarco","sequence":"first","affiliation":[{"name":"Palmetto Orthopaedics of Charleston Mount Pleasant South Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Componovo","sequence":"additional","affiliation":[{"name":"Greater Pittsburgh Orthopaedic Associates Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Barfield","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Medical University of South Carolina and College of Charleston Charleston South Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Liles","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Medical University of South Carolina and College of Charleston Charleston South Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Nietert","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology Medical University of South Carolina and College of Charleston Charleston South Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,5,1]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.D.02003"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00948"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.04.008"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(00)90076-8"},{"key":"e_1_2_2_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2002.25976"},{"key":"e_1_2_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(03)00207-6"},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00196-7"},{"key":"e_1_2_2_9_1","first-page":"213","article-title":"Patient survey of continuous interscalene analgesia at home after shoulder surgery","volume":"20","author":"Chidiac 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