Journal of shoulder and elbow surgery · 2026 · 系統性回顧＋統合分析（依標題推測）
Single-Shot Versus Continuous Interscalene Blockade in Primary Shoulder Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies
肩 · 反式全肩關節置換術
中文閱讀摘要
肩關節置換術統合分析顯示，單次與持續斜角肌間阻斷的24小時鎮痛相近，單次阻斷併發症較少。
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原始摘要
Background
The optimal regional anesthesia strategy for anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty (aTSA/rTSA) remains a subject of debate. While single-shot inter-scalene blocks (SSIBs) are often limited by short duration and potential rebound pain, continuous inter-scalene catheters (CICs) are associated with higher complication rates and procedural complexity. This meta-analysis evaluates the effectiveness and safety of both techniques, specifically investigating the impact of the local anesthetic agent.
Methods
A systematic search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature through March 2026 for randomized controlled trials and observational studies. The primary outcome was pain intensity (Visual Analogue Scale, Numeric Rating Scale) at 24 hours. Secondary outcomes included opioid consumption, length of hospital stay, technical and block-related complications, and procedural costs.
Results
Seven studies involving 2,639 patients were included (1,182 SSIBs and 1,457 CICs). No statistically significant global difference was found regarding 24-hour pain scores (mean difference [MD], -0.23; P = .70) or opioid consumption (P = .91). In sub-group analysis, the CIC was associated with lower pain scores when standard local anesthetics were used (MD, 1.18; P < .001), whereas the SSIB with liposomal bupivacaine was associated with borderline lower pain scores (MD, -1.02; P = .05); however, these differences lie at the lower margin of published thresholds for a minimal clinically important difference in acute post-operative pain. A post hoc analysis at 48 hours (3 studies, 695 patients) showed no significant difference (MD, -0.81; P = .20). The SSIB was associated with a more than 4-fold lower rate of technical and block-related complications (0.4% vs. 4.6%; risk ratio, 0.22; P = .005). No significant difference was observed in the length of hospital stay (P = .45); material costs, compared descriptively, were higher for CICs ($357-$474) than those for SSIBs ($24-$190).
Conclusion
At 24 hours, the SSIB was associated with analgesia comparable with to the CIC, with the direction of effect depending on the local anesthetic agent used. The SSIB was associated with significantly fewer technical and block-related complications and lower material costs. These findings suggest a favorable risk-benefit profile of SSIB for primary shoulder arthroplasty although outcomes beyond 48 hours require further investigation.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1016/j.jse.2026.08.026
- PMID／PMCID
- 42692245
- 作者
- Torrez C, van de Wall BJM, Rippen E, Beeres FJP, Camenzind RS
- 首次發表日期
- 2026-09-03Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 卷未提供 ／ 期未提供 ／ S1058-2746(26)00537-9
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源尚未確認免費全文。 來源授權標示：cc by。
可回溯引用
Torrez C, van de Wall BJM, Rippen E, Beeres FJP, Camenzind RS. Single-Shot Versus Continuous Interscalene Blockade in Primary Shoulder Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies. Journal of shoulder and elbow surgery. 2026:S1058-2746(26)00537-9. PMID: 42692245. doi:10.1016/j.jse.2026.08.026
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