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The average pain trajectories after shoulder surgery vary with different analgesic interventions, according to research presented at the 49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting, held from March 21 to 23 in San Diego.

Sheila Gokul, M.D., from Brigham and Women’s Hospital in Boston, and colleagues examined average pain trajectories with different analgesic interventions for 48 hours after shoulder surgery in a systematic review of randomized controlled trials and cohort studies assessing pain scores according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data were included from 74 studies, with 4,676 patients. The researchers identified three main treatment groups: continuous nerve block (CNB), single shot nerve block (SSNB), and conventional analgesia (CA). At 12 hours postoperatively after all shoulder surgeries, pain scores differed significantly in the presence of CNB, SSNB, and CA (mean, 1.04, 2.39, and 4.52, respectively).

At both 24 and 48 hours, patients with CNB reported very low pain scores on average (1.84 and 1.51, respectively). On direct comparison of CNB and SSNB, there was no significant difference observed between the groups in immediate postoperative pain (1.55 and 1.49); at 12, 24, and 48 hours, the CNB group had significantly lower mean pain scores (1.04 versus 2.39, 1.84 versus 3.05, and 1.51 versus 2.62, respectively).

“In this systematic summative review, we observed the average pain trajectories after shoulder surgery and found that pain was significantly different at most time points in the 48 hours after surgery between conventional therapy, SSNB, and CNB,” the authors write.

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