ABSTRACT
BACKGROUND AND AIMS: Shoulder arthroscopic surgeries can produce intense post-operative pain. Inter-scalene block (ISB) provides good analgesia after shoulder surgery, but concerns over its associated risks have prompted the search for alternatives. Shoulder block (SHB), which includes suprascapular block along with axillary nerve (AN) block, was recently proposed as an alternative to ISB, but evidence of its efficacy is conflicting. The aim of our study was to compare SHB with ISB in shoulder surgery for post-operative analgesia. METHODS: A total of 76 patients scheduled for shoulder arthroscopic surgery were equally divided into 2 groups of 38 patients each: ISB group and SHB group. Both the nerve blocks were achieved by using ultrasound and a nerve stimulator. Visual analogue scale (VAS) scores were evaluated at 1, 4, 6, 12 and 24 h post-operatively. The time to first analgesia request, total analgesic requirement for 24 h post-operatively, patient satisfaction and any complications were recorded. RESULTS: SHB provided equivalent analgesia to ISB in terms of post-operative VAS scores. Time to first analgesic request was 6.2 ± 1.3 h in ISB group and 5.9 ± 1.2 h in SHB group, which was not statistically significant. Complications like subjective dyspnoea and weakness of arm were significantly higher in ISB group compared to SHB group. Patient satisfaction scores were also significantly higher in SHB group compared to ISB group. CONCLUSION: SHB is as effective as ISB for post-operative pain relief and with fewer complications due to selective blockade of suprascapular and axillary nerves.
ABSTRACT
BACKGROUND AND AIMS: Analgesic effect of gabapentin and pregabalin is well-defined in the treatment of neuropathic pain. Postoperative pain after lumbar spine surgery limits the function of patients in the postoperative period, for which the search for ideal analgesic goes on. The aim of the present study was to compare pregabalin and gabapentin as a pre-emptive analgesic in elective lumbar spine surgeries. MATERIAL AND METHODS: In this randomized prospective study, 75 patients were allocated into three groups of 25 each. Group G, group PG, and group P received two capsules of gabapentin 300 mg each, two capsules of pregabalin 150 mg each, and two multivitamin capsules, respectively, with sip of water 1 hour before the expected time of induction of anesthesia. Time for requirement of first dose of rescue analgesia, reduction in postoperative pain score and total dose of rescue analgesic used in first 24 hours postoperatively, and side effects were compared. RESULT: Time for requirement of first dose of rescue analgesic in PG group was 180.12 min and in G group was 104.16 min, which was statistically significant. Both G and PG group had lower visual analogue scale (VAS) score in comparison to P group, which was statistically significant. Consumption of rescue analgesic was less in G and PG group in comparison to P group. Amount of rescue analgesic requirement were low in PG group in comparison to G group (P < 0.001). CONCLUSION: Though both study drugs had produced prolonged postoperative analgesia compared to placebo, pregabalin had better analgesic profile in postoperative period than gabapentin.
