Shoulder Surgery Patients Who Receive Continuous Nerve Blocks Have Less Postop Pain

A study has found that patients undergoing shoulder surgery who had received a continuous nerve block (CNB) experienced less pain following surgery when compared with patients who had received a single-shot nerve block (SSNB) or continuous analgesia (CA).

Significant pain is common in the first 48 hours after shoulder surgery, and patients who receive only conventional oral analgesics may need high levels of opioids to control this pain. The addition of regional nerve blocks can help to reduce the need for opioids.

Which regional blocks work best at reducing pain? That’s what researchers from Brigham and Women’s Hospital wanted to better understand. They also wanted to know the average pain trajectory to gain insight into the optimal timing for providing these blocks.

Their study was selected for 1 of 3 Resident/Fellow Travel awards at the recent 49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting.

For the study, the researchers evaluated 74 published papers that included 4676 patients who had received 1 of 3 treatments: CNB, SSNB, or CA. They found that patients who had received a CNB reported lower pain scores at 24 and 48 hours after surgery.

When comparing just the 2 regional block interventions – CNB and SSNB – they found no significant differences in pain during the immediate postoperative period. However, at 12, 24, and 48 hours after surgery, the CNB patients had lower pain scores.

The researchers noted that the average pain scores remained within the mild range in both regional block groups. If CNB is either unavailable or contraindicated, they said, “SSNB may still provide improved analgesia over non-regional pain management techniques in the early postoperative period.”


Gokul S, Stangle F, Xu C, Badaoui J, Sundararaman L, Schreiber K, Lirk P. Procedure-Specific Acute Pain Trajectories After Shoulder Surgery (Abstract 5088). Presented at the 49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting, March 21-23, 2024, San Diego, California.

CME Updates