Abstract:
BACKGROUND:Major shoulder surgery often results in severe post-operative pain and a variety of interventions have been developed in an attempt to address this. The continuous slow infusion of a local anaesthetic directly into the operative site has recently gained popularity but it is expensive and as yet there is little conclusive evidence that it provides additional benefits over other methods of post-operative pain management. METHODS/DESIGN:This will be a randomised, placebo-controlled trial involving 158 participants. Following diagnostic arthroscopy, all participants will undergo arthroscopic subacromial decompression with or without rotator cuff repair, all operations performed by a single surgeon. Participants, the surgeon, nurses caring for the patients and outcome assessors will be blinded to treatment allocation. All participants will receive a pre-incision bolus injection of 20 mls of ropivacaine 1% into the shoulder and an intra-operative intravenous bolus of parecoxib 40 mg. Using concealed allocation participants will be randomly assigned to active treatment (local anaesthetic ropivacaine 0.75%) or placebo (normal saline) administered continuously into the subacromial space by an elastomeric pump at 5 mls per hour post-operatively. Patient controlled opioid analgesia and oral analgesics will be available for breakthrough pain. Outcome assessment will be at 15, 30 and 60 minutes, 2, 4, 8, 12, 18 and 24 hours, and 2 or 4 months for decompression or decompression plus repair respectively. The primary end point will be average pain at rest over the first 12-hour post-operative period on a verbal analogue pain score. Secondary end points will be average pain at rest over the second 12-hour post-operative period, maximal pain at rest over the first and second 12-hour periods, amount of rescue medication used, length of inpatient stay and incidence of post-operative adhesive capsulitis. DISCUSSION:The results of this trial will contribute to evidence-based recommendations for the effectiveness of pain management modalities following arthroscopic rotator cuff surgery. If the local anaesthetic pain-buster provides no additional benefits over placebo then valuable resources can be put to better use in other ways. TRIAL REGISTRATION:Australian Clinical Trials Register Number ACTR12606000195550.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Coghlan JA,Forbes A,Bell SN,Buchbinder Rdoi
10.1186/1471-2474-9-56subject
Has Abstractpub_date
2008-04-22 00:00:00pages
56issn
1471-2474pii
1471-2474-9-56journal_volume
9pub_type
杂志文章,随机对照试验abstract:BACKGROUD:The osteotomy of the posterolateral overhanging part (PLOP) of the greater trochanter via posterior approach has been used for the hip arthroplasty for decades with good results. However, the osteotomy method remains undefined and the precise adjacent structures around PLOP have not been reported. The purpose...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-3088-9
更新日期:2020-02-24 00:00:00
abstract:BACKGROUND:Shoulder disorders are common problems in primary health care. The course of disease of patients consulting for a new episode of a shoulder problem has been thought to be benign. In this prospective cohort study, we assessed the one-year consumption of medical resources and clinical outcome of shoulder disor...
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pub_type: 杂志文章
doi:10.1186/1471-2474-14-348
更新日期:2013-12-13 00:00:00
abstract:BACKGROUND:Although the pathogenesis of adolescent idiopathic scoliosis (AIS) remains controversial, genetic factors are thought to play key roles in the development of AIS. In a recent genome-wide association study, a polymorphism in the interleukin-17 receptor C (IL-17RC) gene was reported to be associated with the s...
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pub_type: 杂志文章
doi:10.1186/1471-2474-13-181
更新日期:2012-09-21 00:00:00
abstract:BACKGROUND:The use of autogenous bone graft is a well-known technique for reconstruction of tibial bone defects in primary total knee arthroplasty (TKA). In cases where the size of the bone graft is inappropriate, the stability of bone graft fixation and subsequent bone graft to host bone incorporation may be compromis...
journal_title:BMC musculoskeletal disorders
pub_type: 临床试验,杂志文章
doi:10.1186/s12891-017-1826-4
更新日期:2017-11-29 00:00:00
abstract:BACKGROUND:Advice to remain active and normalisation of activity are commonly prescribed in the management of low back pain (LBP). However, no research has assessed whether objective measurements of physical activity predict outcome and recovery in acute low back pain. METHOD:The aims of this study were to assess the ...
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pub_type: 杂志文章
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更新日期:2013-04-05 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12891-020-03788-z
更新日期:2020-11-18 00:00:00
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journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2474-7-31
更新日期:2006-03-17 00:00:00
abstract:BACKGROUND:Understanding the pattern of recovery and expected rate of change after shoulder arthroplasty is helpful to clinicians and patients for setting realistic expectations and goals. The purpose of this study was to describe the pattern of recovery over a 2-year period for patients receiving either a Total Should...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-15-306
更新日期:2014-09-18 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12891-020-03493-x
更新日期:2020-07-22 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12891-019-2764-0
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journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-04-08 00:00:00
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pub_type: 杂志文章
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更新日期:2011-11-01 00:00:00
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更新日期:2020-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-04-29 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2474-13-158
更新日期:2012-08-27 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2474-11-73
更新日期:2010-04-20 00:00:00
abstract:BACKGROUND:Chronic low back pain (CLBP) is a highly disabling morbidity with high social, economic and individual effects. Demographic, occupational and behavioral changes that took place in Brazil over the last decade are related with an increasing burden of chronic conditions. Despite these changes, comparison studie...
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pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2018-08-02 00:00:00
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pub_type: 杂志文章
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更新日期:2019-11-13 00:00:00
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journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-015-0811-z
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:Little information exists on the presentation of symptomatic venous thromboembolism (VTE) in orthopaedic surgery when a defined protocol for thromboprophylaxis is used. The objective with this study was to establish the VTE rate and mortality rate in orthopaedic surgery. METHODS:We performed a prospective, ...
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更新日期:2013-06-04 00:00:00
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journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
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更新日期:2007-11-06 00:00:00
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pub_type: 杂志文章
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更新日期:2020-04-14 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12891-020-03646-y
更新日期:2020-09-25 00:00:00
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journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
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更新日期:2010-06-13 00:00:00
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pub_type: 杂志文章
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更新日期:2008-02-19 00:00:00