Comparison of clinical efficacy among remifentanil, nicardipine, and remifentanil plus nicardipine continuous infusion for hypotensive anesthesia during arthroscopic shoulder surgery.

PURPOSE: Hypotensive anesthesia is crucial during arthroscopic shoulder surgery to reduce bleeding and allow for clear visibility. The aim of this study was to compare the clinical efficacy of continuous infusion of remifentanil, nicardipine, and remifentanil plus nicardipine to control hypotensive anesthesia in arthroscopic shoulder surgery. METHODS: For this study, we enrolled 45 consecutive patients who were scheduled to have arthroscopic rotator cuff repair surgery and randomly allocated them into remifentanil (group R, n = 15), nicardipine (group N, n = 15), and remifentanil plus nicardipine (group RN, n = 15) groups. During the surgeries, these drugs were administered with continuous infusion. We analyzed the mean arterial pressure (MAP) and heart rate during surgery, stay time in the recovery room, visual analogue scale (VAS) scores, use of antiemetics in the recovery room, and postoperative blood urea nitrogen and creatinine changes. RESULTS: The VAS score in the recovery room was higher for group R (mean 5.6, SD 1.4) than for groups N (mean 3.9, SD 0.9) and RN (mean 4.0, SD 1.1; p = 0.000). There were no statistical differences regarding other clinical variables among the three groups (all p > 0.05) except for MAP at 120 min of surgery between groups N and RN (N: 84.67 (SD 10.7) mmHg, RN: 65.4 (SD 9.2) mmHg, p = 0.027). CONCLUSION: The continuous infusion of remifentanil plus nicardipine appeared to be advantageous for maintaining hypotensive anesthesia until 120 min of arthroscopic shoulder surgery without rebound pain in a postanesthesia care unit.

Cross-cultural adaptation, validity and reliability of the Korean version of the Kerlan-Jobe Orthopedic Clinic shoulder and elbow score.

BACKGROUND: The Kerlan-Jobe Orthopedic Clinic shoulder and elbow score (KJOC score) was developed for assessing performance and function in overhead athletes with shoulder and elbow injury and recently adapted as the standard score for overhead athletes in Major League Baseball. However, the Korean version of the KJOC score was not developed in the literature. The aim of the current study was to adapt the English version of the KJOC score to develop a Korean version (K-KJOC) and to evaluate its validity and reliability. METHODS: A total of 52 professional baseball players in the Korean Baseball League completed the K-KJOC at two-week intervals during the off-season. The QuickDASH (11-point Disabilities of the Arm, Shoulder and Hand) score was also performed to evaluate the construct validity of the K-KJOC score. The internal consistency of reliability and test-retest reliability were assessed as well. RESULTS: The K-KJOC score was correlated with the Quick DASH - disability/symptom (-0.309, ~-0.268, p < 0.05), Quick DASH - work (r = -0.721 to -0.671, p = 0.000) and QuickDASH - sports (r = -0.721 to -0.714, p = 0.000). The internal consistency of the K-KJOC score was excellent (Cronbach's α: 0.917-0.966), and the intra-class correlation coefficients of test-retest reliability for the 10 items for the K-KJOC score were fair to excellent (ICC 0.505-0.937, p < 0.05). CONCLUSION: The K-KJOC score appeared to be a valid and reliable tool for assessing shoulder and elbow injuries in Korean overhead athletes.