1.
Intra-articular injection, subacromial injection, and hydrodilatation for primary frozen shoulder: a randomized clinical trial.
Yoon, JP, Chung, SW, Kim, JE, Kim, HS, Lee, HJ, Jeong, WJ, Oh, KS, Lee, DO, Seo, A, Kim, Y
Journal of shoulder and elbow surgery. 2016;(3):376-83
Abstract
BACKGROUND The aim of this prospective randomized study was to compare the efficacy of 3 injection methods, intra-articular injection, subacromial injection, and hydrodilatation (HD), in the treatment of primary frozen shoulder. METHODS Patients with primary frozen shoulder were randomized to undergo intra-articular injection (n = 29), subacromial injection (n = 29), or HD (n = 28). Evaluations using a visual analog scale for pain, Simple Shoulder Test, Constant score, and passive range of shoulder motion were completed before treatment and 1 month, 3 months, and 6 months after treatment. RESULTS Among the 3 injection methods for primary frozen shoulder, HD resulted in a greater range of motion in forward flexion and external rotation, a lower visual analog scale score for pain after 1 month, and better outcomes for all functional scores after 1 month and 3 months of follow-up. However, there were no significant differences in any clinical outcomes among the 3 groups in the final follow-up at 6 months. CONCLUSIONS Although HD yielded more rapid improvement, the 3 injection methods for primary frozen shoulder resulted in similar clinical improvement in the final follow-up at 6 months.
2.
Effect of normal saline irrigation on attenuation of shoulder tip pain and on β-endorphin levels after laparoscopic cholecystectomy.
Seo, YK, Lee, HJ, Ha, TK, Lee, KG
Journal of laparoendoscopic & advanced surgical techniques. Part A. 2012;(4):311-4
Abstract
AIM: The purpose of this study was to evaluate the effect of saline washout under the diaphragm on postoperative shoulder tip pain (STP) and β-endorphin (βE) levels in patients who had undergone laparoscopic cholecystectomy (LC). METHODS Between December 2010 and March 2011, 50 patients requiring cholecystectomy for benign gallbladder disease were enrolled in this study. Twenty-five patients (Group 1) underwent LC without saline irrigation, whereas the other 25 were operated on with saline irrigation (30 mL/kg) under the diaphragm (Group 2). Plasma levels of βE were measured before and after the operation. The degree of STP following LC was assessed using a visual analog pain scale (VAS) at 6, 12, and 24 hours postoperatively. RESULTS Eight patients in Group 1 (32.0%) and seven patients in Group 2 (28.0%) complained of STP. There was no significant difference between the two groups in operation time, postoperative hospital length, postoperative βE, dose of analgesics, or VAS at 6, 12, and 24 hours after surgery. The intensity of abdominal pain (AP) was significantly higher than that of STP. Significantly elevated levels (11.3±5.1 pg/mL) of βE were observed postoperatively when compared with preoperative levels (9.7±5.2 pg/mL) (P=.02). CONCLUSIONS Normal saline irrigation under the diaphragm does not reduce postoperative STP after LC. Ancillary techniques to reduce AP and STP should be considered.