{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:42:36Z","timestamp":1792190556296,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100021084","name":"Ulsan University Hospital","doi-asserted-by":"publisher","award":["UUH-2023-05"],"award-info":[{"award-number":["UUH-2023-05"]}],"id":[{"id":"10.13039\/501100021084","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","arthroscopyjournal.org","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the effects of additional multimodal shoulder injections on postoperative rebound pain in patients undergoing arthroscopic rotator cuff repair (ASRCR) under interscalene brachial plexus block (ISBPB) anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010blind randomized controlled trial was conducted with 67 patients between April and December 2023. Patients undergoing ASRCR who received ISBPB anesthesia, rather than general anesthesia, with a minimum follow\u2010up period of 48 hours were included. The injection group received 40 mL of 0.75% ropivacaine, 20 mg morphine, 1:200,000 epinephrine, and saline solution, totaling 100 mL. After surgery, the injection was administered to the subacromial space (50 mL) with blind suprascapular nerve block (25 mL) and blind axillary nerve block (25 mL). Control subjects received 100 mL of saline solution. Intravenous patient\u2010controlled analgesia (IV\u2010PCA) was used as adjuvant analgesia for all patients. The primary outcome was evaluated using the visual analog scale (VAS) pain score at 12 hours after surgery, with secondary outcomes of the incidence of rebound pain and VAS pain scores at 0, 2, 4, 8, 24, 36, and 48 hours postoperatively. Fentanyl in the IV\u2010PCA and rescue analgesic amounts, complications, and patient satisfaction were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010seven patients (32 in the injection group, 35 in the control group) with a mean age of 61.1 \u00b1 9.0 years were included. The primary outcome assessment, VAS pain score at 12 hours, significantly favored the injection group (2.7 \u00b1 0.93 vs 4.1 \u00b1 1.70,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). The incidence of rebound pain was 18.8% and 65.7% in the injection and control groups, respectively (18.8% vs 65.7%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). The injection group reported better VAS pain scores at 24, 36, and 48 hours and lower fentanyl use over the 48\u2010hour postoperative period (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .014). The use of rescue analgesics was similar between groups, and no complications were associated with multimodal shoulder injections. Satisfaction levels were similar in both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present study found that patients who underwent multimodal shoulder injections during ASRCR under ISBPB anesthesia had significantly lower VAS pain scores at 12 hours postoperatively and reduced incidence of rebound pain compared with the control group. Pain levels were consistently lower from 12 to 48 hours postoperatively. Additionally, the injection group had reduced opioid consumption within the first 48 hours postoperatively, with no complications observed.<\/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.2024.07.029","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T05:41:04Z","timestamp":1723614064000},"page":"1291-1298","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"title":["Rebound Pain After Arthroscopic Cuff Repair With Interscalene Brachial Plexus Block Anesthesia Is Reduced by Surgeon\u2010Administered Multimodal Shoulder Injections: A Prospective Randomized Controlled Trial"],"prefix":"10.1002","volume":"41","author":[{"given":"Ki\u2010Bong","family":"Park","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Ulsan College of Medicine Ulsan University Hospital Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun\u2010Oh","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Medicine Ulsan University College of Medicine Ulsan University Hospital Ulsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Ulsan College of Medicine Ulsan University Hospital Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Dae","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Ulsan College of Medicine Ulsan University Hospital Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2009.1.1.48"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2021.08.008"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000688"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.17085\/apm.22254"},{"key":"e_1_2_3_6_2","first-page":"738","article-title":"Selective suprascapular and axillary nerve block versus interscalene plexus block for pain control after arthroscopic shoulder surgery: A noninferiority randomized parallel\u2010controlled clinical trial","volume":"43","author":"Neuts A.","year":"2018","journal-title":"Reg Anesth Pain 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