Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital

PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure-specific postoperative pain management recommendations

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


  1. Challenges in optimising recovery after emergency laparotomy

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  2. The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

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

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  4. Development of evidence-based recommendations for procedure-specific pain management: PROSPECT methodology

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • O Toma
  • B Persoons
  • E Pogatzki-Zahn
  • M Van de Velde
  • G P Joshi
  • PROSPECT Working Group collaborators (Henrik Kehlet member)
Vis graf over relationer

Rotator cuff repair can be associated with significant and difficult to treat postoperative pain. We aimed to evaluate the available literature and develop recommendations for optimal pain management after rotator cuff repair. A systematic review using procedure-specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in English from 1 January 2006 to 15 April 2019 assessing postoperative pain after rotator cuff repair using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. Out of 322 eligible studies identified, 59 randomised controlled trials and one systematic review met the inclusion criteria. Pre-operative and intra-operative interventions that improved postoperative pain were paracetamol, cyclo-oxygenase-2 inhibitors, intravenous dexamethasone, regional analgesia techniques including interscalene block or suprascapular nerve block (with or without axillary nerve block) and arthroscopic surgical technique. Limited evidence was found for pre-operative gabapentin, perineural adjuncts (opioids, glucocorticoids, or α-2-adrenoceptor agonists added to the local anaesthetic solution) or postoperative transcutaneous electrical nerve stimulation. Inconsistent evidence was found for subacromial/intra-articular injection, and for surgical technique-linked interventions, such as platelet-rich plasma. No evidence was found for stellate ganglion block, cervical epidural block, specific postoperative rehabilitation protocols or postoperative compressive cryotherapy. The analgesic regimen for rotator cuff repair should include an arthroscopic approach, paracetamol, non-steroidal anti-inflammatory drugs, dexamethasone and a regional analgesic technique (either interscalene block or suprascapular nerve block with or without axillary nerve block), with opioids as rescue analgesics. Further randomised controlled trials are required to confirm the influence of the recommended analgesic regimen on postoperative pain relief.

Udgave nummer10
Sider (fra-til)1320-1331
Antal sider12
StatusUdgivet - okt. 2019

Bibliografisk note

© 2019 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

ID: 58096831