Interscalene brachial plexus block is the standard regional analgesic technique for shoulder surgery. Given its adverse effects, alternative techniques have been explored. Reports suggest that the erector spinae plane block may potentially provide effective analgesia following shoulder surgery. However, its analgesic efficacy for shoulder surgery compared with placebo or local anaesthetic infiltration has never been established. We conducted a randomised controlled trial to compare the analgesic efficacy of pre-operative T2 erector spinae plane block with peri-articular infiltration at the end of surgery. Sixty-two patients undergoing arthroscopic shoulder repair were randomly assigned to receive active erector spinae plane block with saline peri-articular injection (n = 31) or active peri-articular injection with saline erector spinae plane block (n = 31) in a blinded double-dummy design. Primary outcome was resting pain score in recovery. Secondary outcomes included pain scores with movement; opioid use; patient satisfaction; adverse effects in hospital; and outcomes at 24 h and 1 month. There was no difference in pain scores in recovery, with a median difference (95%CI) of 0.6 (−1.9–3.1), p = 0.65. Median postoperative oral morphine equivalent utilisation was significantly higher in the erector spinae plane group (21 mg vs. 12 mg; p = 0.028). Itching was observed in 10% of patients who received erector spinae plane block and there was no difference in the incidence of significant nausea and vomiting. Patient satisfaction scores, and pain scores and opioid use at 24 h were similar. At 1 month, six (peri-articular injection) and eight (erector spinae plane block) patients reported persistent pain. Erector spinae plane block was not superior to peri-articular injection for arthroscopic shoulder surgery.

中文翻译：

---

肩关节镜手术后竖脊肌平面阻滞与关节周围注射控制疼痛：一项随机对照试验

肌间沟臂丛神经阻滞是肩部手术的标准局部镇痛技术。鉴于其不利影响，已经探索了替代技术。报告表明，竖脊肌平面阻滞可能在肩部手术后提供有效的镇痛。然而，与安慰剂或局部麻醉剂浸润相比，其对肩部手术的镇痛效果尚未确定。我们进行了一项随机对照试验，比较术前 T2 竖脊肌平面阻滞与手术结束时关节周围浸润的镇痛效果。62 名接受关节镜肩关节修复术的患者被随机分配接受双盲双盲组中接受主动竖脊肌平面阻滞联合盐水关节周围注射（n = 31）或主动关节周围注射盐水竖脊肌平面阻滞（n = 31） - 假人设计。主要结果是恢复时的静息疼痛评分。次要结果包括运动疼痛评分；阿片类药物的使用；患者满意度；医院的不良反应；以及 24 小时和 1 个月的结果。恢复时的疼痛评分没有差异，中位数差异 (95%CI) 为 0.6 (-1.9-3.1)，p = 0.65。竖脊肌平面组术后口服吗啡等效使用率中位数显着更高（21 mg 对 12 mg；p = 0.028）。接受竖脊肌平面阻滞的患者有 10% 出现瘙痒，明显恶心和呕吐的发生率无差异。患者满意度评分、疼痛评分和 24 小时阿片类药物使用情况相似。1 个月时，6 名（关节周围注射）和 8 名（竖脊肌平面阻滞）患者报告持续疼痛。对于肩关节镜手术，竖脊肌平面阻滞并不优于关节周围注射。