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More Dangerous and Less Effective – Why Would Any Patient Want to Use a Post-Operative Pain Pump?

07/9/2009
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A recent study published by scientists in Victoria, Australia provides even more compelling evidence that post-operative use of pain pumps in patients undergoing shoulder surgeries is a bad idea.   A number of researchers have noted that patients who utilized post-operative pain pumps which bathed their shoulder joints with anesthetic drugs were at high risk for the development of cartilage damage.  The condition was so striking (and virtually unprecedented as a result of other causes) that the condition was termed Post-Arthroscopic Glenohumeral Chondrolysis.  Most orthopaedic surgeons no longer place pain pump catheters in the intra-articular space as a result of the discovery of this devastating complication. 

Eighty-eight patients undergoing shoulder surgeries (rotator cuff repair or decompression) participated in this latest study.   The patients were given 1% ropivacaine and intra-operative IV parecoxib (a Cox 2 inhibitor similar to Vioxx, Bextra or Celebrex that is marketed under the name Dynastat) in connection with the surgery and then randomly assigned to a placebo or control group or given .75% ropivacaine by an elastomeric pump at 5 ml/hour.  The patients receiving the anesthetic drug report a “significant but clinically unimportant” decrease in pain for the first 12 hours following surgery.  Once adjustments were made for opioid use by the patients, there was no difference in the level of pain relief experienced by those who received intra-articular injections of pain medications versus those receiving a placebo.

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