Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty
Background: Peripheral nerve block (PNB) is effective for pain management after shoulder arthroplasty. Our study investigated the impact of regional anesthesia on perioperative pain management following total elbow arthroplasty (TEA). We aimed to determine whether single shot anesthesia (SSA) or con...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
|
| Series: | JSES International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638325000854 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850114499784212480 |
|---|---|
| author | Tamara Babasiz, MD Michael Hackl, MD, PhD Sebastian Wegmann, MD Jan Hockmann, MD Kai Hoffeld, MD Lars P. Müller, MD, PhD Tim Leschinger, MD, PhD |
| author_facet | Tamara Babasiz, MD Michael Hackl, MD, PhD Sebastian Wegmann, MD Jan Hockmann, MD Kai Hoffeld, MD Lars P. Müller, MD, PhD Tim Leschinger, MD, PhD |
| author_sort | Tamara Babasiz, MD |
| collection | DOAJ |
| description | Background: Peripheral nerve block (PNB) is effective for pain management after shoulder arthroplasty. Our study investigated the impact of regional anesthesia on perioperative pain management following total elbow arthroplasty (TEA). We aimed to determine whether single shot anesthesia (SSA) or continuous peripheral nerve block (CPNB) reduces opioid usage and improves postoperative pain levels compared to general anesthesia alone. Methods: A retrospective analysis evaluated 78 patients who underwent TEA for perioperative pain management, including nonopioid, opioid medications, and on-demand opioid use. Postoperative pain was assessed using the Numeric Rating Scale (NRS). Patients were divided into 3 groups based on anesthesia type: Group 1 received a PNB intraoperatively and a CPNB; Group 2 received SSA; and Group 3 underwent general anesthesia alone. Pain management and perception were compared over 5 days postoperatively using the Mann-Whitney U test. Results: Group 1 had significantly lower intraoperative opioid usage compared to group 3 (P = .0423) and required fewer opioids postoperatively (P = .0114). Group 1 also reported lower NRS scores, indicating better pain relief (P < .0001). Group 2 showed a trend toward reduced intraoperative (P = .4372) and postoperative opioid (P = .1107) use compared to group 3, although with no statistical significance. Group 2 had significantly lower NRS scores than group 3 (P = .0023). Conclusion: In this first study on PNB and CPNB in TEA, we showed that CPNB reduces perioperative opioid use and improves postoperative pain. SSA offers no significant advantage over CPNB in reducing opioid usage. Avoiding systemic opioids and their adverse effects is particularly beneficial for elderly patients. |
| format | Article |
| id | doaj-art-a8098170dbef4ff48b469b4ce00986de |
| institution | OA Journals |
| issn | 2666-6383 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj-art-a8098170dbef4ff48b469b4ce00986de2025-08-20T02:36:50ZengElsevierJSES International2666-63832025-07-01941251125610.1016/j.jseint.2025.03.003Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplastyTamara Babasiz, MD0Michael Hackl, MD, PhD1Sebastian Wegmann, MD2Jan Hockmann, MD3Kai Hoffeld, MD4Lars P. Müller, MD, PhD5Tim Leschinger, MD, PhD6Corresponding author: Tamara Babasiz, MD, Department for Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Strasse 62, Cologne 50937, Germany.; Faculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyFaculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyFaculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyFaculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyFaculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyFaculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyFaculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, GermanyBackground: Peripheral nerve block (PNB) is effective for pain management after shoulder arthroplasty. Our study investigated the impact of regional anesthesia on perioperative pain management following total elbow arthroplasty (TEA). We aimed to determine whether single shot anesthesia (SSA) or continuous peripheral nerve block (CPNB) reduces opioid usage and improves postoperative pain levels compared to general anesthesia alone. Methods: A retrospective analysis evaluated 78 patients who underwent TEA for perioperative pain management, including nonopioid, opioid medications, and on-demand opioid use. Postoperative pain was assessed using the Numeric Rating Scale (NRS). Patients were divided into 3 groups based on anesthesia type: Group 1 received a PNB intraoperatively and a CPNB; Group 2 received SSA; and Group 3 underwent general anesthesia alone. Pain management and perception were compared over 5 days postoperatively using the Mann-Whitney U test. Results: Group 1 had significantly lower intraoperative opioid usage compared to group 3 (P = .0423) and required fewer opioids postoperatively (P = .0114). Group 1 also reported lower NRS scores, indicating better pain relief (P < .0001). Group 2 showed a trend toward reduced intraoperative (P = .4372) and postoperative opioid (P = .1107) use compared to group 3, although with no statistical significance. Group 2 had significantly lower NRS scores than group 3 (P = .0023). Conclusion: In this first study on PNB and CPNB in TEA, we showed that CPNB reduces perioperative opioid use and improves postoperative pain. SSA offers no significant advantage over CPNB in reducing opioid usage. Avoiding systemic opioids and their adverse effects is particularly beneficial for elderly patients.http://www.sciencedirect.com/science/article/pii/S2666638325000854Level IIIRetrospective Cohort ComparisonTreatment Study |
| spellingShingle | Tamara Babasiz, MD Michael Hackl, MD, PhD Sebastian Wegmann, MD Jan Hockmann, MD Kai Hoffeld, MD Lars P. Müller, MD, PhD Tim Leschinger, MD, PhD Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty JSES International Level III Retrospective Cohort Comparison Treatment Study |
| title | Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty |
| title_full | Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty |
| title_fullStr | Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty |
| title_full_unstemmed | Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty |
| title_short | Influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty |
| title_sort | influence of single shot and continuous peripheral nerve block on opioid consumption and perioperative pain management in patients undergoing total elbow arthroplasty |
| topic | Level III Retrospective Cohort Comparison Treatment Study |
| url | http://www.sciencedirect.com/science/article/pii/S2666638325000854 |
| work_keys_str_mv | AT tamarababasizmd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty AT michaelhacklmdphd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty AT sebastianwegmannmd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty AT janhockmannmd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty AT kaihoffeldmd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty AT larspmullermdphd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty AT timleschingermdphd influenceofsingleshotandcontinuousperipheralnerveblockonopioidconsumptionandperioperativepainmanagementinpatientsundergoingtotalelbowarthroplasty |