Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

A randomized controlled trial evaluating the impact of selective axillary nerve block after arthroscopic subacromial decompression

Research output: Contribution to journalJournal articleResearchpeer-review

  1. The effect of preoperative dexamethasone on pain 1 year after lumbar disc surgery: a follow-up study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Thoracic epidural analgesia reduces gastric microcirculation in the pig

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. The association between epidural analgesia and mortality in emergency abdominal surgery: A population-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Volume of ropivacaine 0.2% and sciatic nerve block duration:a randomised, blinded trial inhealthy volunteers

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. A difficulty with the DIFFMASK score is the difficult statistics - a reply

    Research output: Contribution to journalComment/debateResearchpeer-review

View graph of relations

BACKGROUND: The sensory innervation of the shoulder is complex and there are variations in the branching patterns of the sensory fibres. Articular branches from the axillary nerve to the subacromial bursa are described in more than 50% of investigated shoulders but the isolated contribution of sensory input from the axillary nerve has never been investigated clinically. We hypothesized that a selective block of the axillary nerve would reduce morphine consumption and pain after arthroscopic subacromial decompression.

METHODS: We included 60 patients in a randomized, blinded, placebo-controlled study. Patients were randomized to a preoperative selective ultrasound-guided axillary nerve block with 20 mL ropivacaine (7.5 mg/mL) or 20 mL saline. Primary outcome was intravenous morphine consumption 0-4 h postoperatively. Secondary outcome was postoperative pain evaluated by a visual analogue scale (VAS) score (0-100).

RESULTS: We analysed data from 50 patients and found no significant difference in 0-4 h postoperative morphine consumption between the two groups (ropivacaine 14 mg, placebo 18 mg (P = 0.12)). There was a reduction in postoperative pain: VAS 0-4 h (area under the curve) (ropivacaine 135, placebo 182 (P = 0.03)), VAS after 8 h (ropivacaine 9, placebo 20 (P = 0.01)) and VAS after 24 h (ropivacaine 7, placebo 18 (P = 0.04)). Eight out of 19 patients with a successful selective axillary nerve block needed an interscalene brachial plexus escape block.

CONCLUSIONS: Selective block of the axillary nerve has some pain relieving effect, but in this setting the effect was unpredictable, variable and far from sufficient in a large proportion of the patients.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT01463865). Registered: November 1, 2011.

Original languageEnglish
JournalBMC Anesthesiology
Volume20
Issue number1
Pages (from-to)33
ISSN1471-2253
DOIs
Publication statusPublished - 2020

ID: 59211275