Patient-controlled lidocaine analgesia for acromioplasty surgery

Twenty-four consecutive patients undergoing shoulder acromioplasty were giv en postoperative analgesia with a new method in which a patient-controlled continuous infusion of lidocaine infiltrated the subacromial space. Sevente en of the acromioplasties were done with arthroscopy, whereas 7 were perfor med with an open procedure. A 2% solution of lidocaine without epinephrine was used for both a continuous dose of 2 cc/h and patient-controlled interv al doses of I cc administered at 15-minute intervals. The catheter was left in place for 72 hours. We prospectively studied complications, the patient 's subjective pain level, the amount of supplementary pain medication used and serum levels of lidocaine. In addition, we evaluated a control group of 24 patients undergoing acromioplasty by the same surgeon without the use o f this method of pain control. No wound complications occurred. No adverse reactions to lidocaine or overdose of lidocaine occurred. Blood levels of l idocaine averaged 0.3 mu g/mL in the 12 patients studied. Subjective pain l evels and the amount of supplementary pain medication used were both lower in the group receiving patient-controlled lidocaine analgesia at statistica lly significant levels (P =.168 measuring subjective pain level, and P=.021 2 measuring supplementary pain medication use). Patient-controlled lidocain e analgesia in the subacromial space appears to be a safe method for achiev ing high levels of pain control in patients undergoing an acromioplasty.